AIKIDO NLC TWO YEAR SEMINAR 8/16/2025
This is a digital version of our registration form. Some paperwork will need to be signed in person. After completed an invoice will be emailed.
Name
First Name
Last Name
Home Dojo:
Rank
Unranked
White Belt
Black Belt
Aikido Instructor
Date of Birth
-
Month
-
Day
Year
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Day Attending
Saturday ONLY ($45)
Payment type
Invoice (Credit card prepay)
Cash/Check/CC at Event
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact
First Name
Last Name
Relation
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Are you in one of these groups
USAF MEMBER
FOUND FRIEND MEMBER
NONE
GSK
Parent/Guardian Signature
Submit
Should be Empty: