Tournament Registration

 

Champs Cup Karate Championships National Qualifier MAY 12th, 2012 Please complete this form then proceed to the Pay Pal link. Registrations must be accompanied by payment or your form will be discarded.  Feel free to contact our staff for any questions. 770-947-5212 First Name: Last Name: Dojo: DIVISIONS: KA -KO -KU Gender: Birthdate: Age: Skill Level: Address Street 1: City: Zip Code: (5 digits) State: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Daytime Phone: Evening Phone: Email: Comments: Enter comments here!

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