TIKKA Membership Application

Tracy's International Kenpo Karate Association

2026 Membership Application
Name*

First NameLast Name
Email*
example@example.com
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
What is your age?*
Martial Arts Style*
Current Rank*
School Name*
Instructor*
School Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Studio Phone #
Liability Waiver and Hold Harmless Agreement:

By submission of this registration form, I, we, or parent(s) of the above named person(s), are receiving a one-year membership in the Tracy's International Kenpo Karate Association (TIKKA) and I/We assume all risks incidental to participation in TIKKA. I/We do further release, absolve, indemnify and hold harmless Tracy’s International Kenpo Karate Association (TIKKA), TIKKA Officers, TIKKA Advisors, TIKKA Board of Directors and TIKKA volunteers from any injury (personal or financial). In case of injury to my/our child/children or myself, I/We hereby waive all claims against TIKKA, TIKKA Officers, TIKKA Advisors, TIKKA Board of Directors and TIKKA volunteers.

The mission of TIKKA is to preserve, protect and promote the martial arts legacy of Al Tracy, namely the Tracy System of Kenpo. As a member of TIKKA, I agree to conduct myself in a manner that is consistent with this mission.
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My Products*
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Annual Individual Membership
Includes certificate of membership and one (1) association patch

$29.95 Quantity
Item subtotal:$0.00



Additional Patches
$10.00 Quantity
Item subtotal:$0.00



Annual Instructor Membership
$50.00 Quantity
Item subtotal:$0.00



Annual School Membership
$100.00 Quantity
Item subtotal:$0.00



Tax Deductible Donation
Donation to TIKKA

$5.00 Quantity
Item subtotal:$0.00



Total

$0.00

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Tracy's International Kenpo Karate Association