Canada Cup 2014 Team Registration Form
Province* Choose Province Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
Dojo*
Instructor*
eMail*
Event * choose event Team Kata Team Kumite Team Kata Bunkai Team Enbu
Gender* M F
Name 1 Rank* Choose Belt Rank Kyu 3rd (1st Brown) Kyu 2nd (2nd Brown) Kyu 1st (3rd Brown) 1st Dan (Shodan) 2nd Dan (Nidan) 3rd Dan (Sandan) 4th Dan (Yondan) 5th Dan (Godan) 6th Dan (Rukudan) 7th Dan (Shichidan) 8th Dan (Hachidan) other
Name 2 Rank* Choose Belt Rank Kyu 3rd (1st Brown) Kyu 2nd (2nd Brown) Kyu 1st (3rd Brown) 1st Dan (Shodan) 2nd Dan (Nidan) 3rd Dan (Sandan) 4th Dan (Yondan) 5th Dan (Godan) 6th Dan (Rukudan) 7th Dan (Shichidan) 8th Dan (Hachidan) other
Name 3 Rank* Choose Belt Rank Kyu 3rd (1st Brown) Kyu 2nd (2nd Brown) Kyu 1st (3rd Brown) 1st Dan (Shodan) 2nd Dan (Nidan) 3rd Dan (Sandan) 4th Dan (Yondan) 5th Dan (Godan) 6th Dan (Rukudan) 7th Dan (Shichidan) 8th Dan (Hachidan) other
Alternate Rank Choose Belt Rank Kyu 3rd (1st Brown) Kyu 2nd (2nd Brown) Kyu 1st (3rd Brown) 1st Dan (Shodan) 2nd Dan (Nidan) 3rd Dan (Sandan) 4th Dan (Yondan) 5th Dan (Godan) 6th Dan (Rukudan) 7th Dan (Shichidan) 8th Dan (Hachidan) other
Late Payment Fee (after May 2)
Fee
Total Fee
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