Registration form for the 2012 Brandon Invitational Tournament

1. Competitors Registration
First Annual Invitational Karate Competition
Saturday October 13th, 2012
(2:00 to 4:00 p.m.)
Name _______________________________________________________________________
first last
Dojo Name __________________________________________________________________
Age _______________________
Rank or Belt Color _____________________
Gender _______________
Events
Kumite (only)______ Kata (only) _______ Both events_______
Team Kata ______ Team Kumite ______ Team Bunkai ________
Children (6-17) _____ Adults_______________
Kata or Kumite ONLY $15.00 Kata or Kumite ONLY $25.00
Both $20.00 Both $ 30.00
Teams $30.00 (3) Teams $45.00 (3)
Kata Team___________________,______________________,___________________
Kumite Team __________________,______________________,__________________
Bunkai Team___________________,______________________,__________________
st
DEADLINE: TO YOUR INSTRUCTOR Payment and registration – October 1 , 2012
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ATTENTION INSTRUCTORS:**** Make sure this sheet is completed and included
with your rollup sheet.
Entry can be mailed or dropped off at: 114 Whillier Drive, Brandon, Mb. R7B 0X0
Please include roll sheet. If you need more information you can contact Wendy
Flannigan 204-727-8625 or email: wflannigan@mts.net