2023 AKANA Family Reunion Payment Form

If you are not a current AKANA member and would like to join, please go to the AKANA webpage and click on the Join link to fill out an application online. Thank you. For any questions, please call our office or email us.

Please fill out one payment form for each student participating. Thank you.

Name*

First NameLast Name

Name of Dojo*

Belt Rank*

Example: 5th Kyu Blue or 5th Dan Black

Black Belt AKANA Verification # if applicable

Example: WA-002-001-YM (listed on AKANA Black Belt Member webpage, membership card, or rank certificate)

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

What is your tee shirt size?*

Include Special Instructions

My Products

AKANA Member PriceMust be an AKANA Member in good standing. If not, and you would like to join, go to the AKANA website, click on the membership application link, and apply. Price includes all seminars with lunch on both days and banquet dinner along with special AKANA member events. Must register by June 1, to receive this discount price plus a free 2025 AKANA Family Reunion Tee Shirt (value of $30).

$195.00

Non-AKANA Member PricePrice includes all seminars with lunch on both days and banquet dinner. We encourage you to become a member of AKANA and receive the AKANA discounted price.

$295.00

Friday Only Seminars with Lunch Product Image

Friday Only Seminars with LunchIncludes all seminars on Friday. This price includes lunch. Seminars are subject to change.

$150.00
Item subtotal:$0.00

Saturday Only Seminars with Lunch Product Image

Saturday Only Seminars with LunchIncludes all seminars on Saturday. This price includes lunch. Seminars are subject to change.

$150.00
Item subtotal:$0.00

Awards Dinner for Additional Family Members Product Image

Awards Dinner for Additional Family MembersPrice of the awards dinner on Saturday Afternoon for additional family members that are not registered for the event.

$50.00

	Quantity	Price
Adult (Age 12 & up)		$50.00
Child (Age 11 & under)		$30.00

Item subtotal:$0.00

AKANA Family Reunion Promotion Fee Product Image

AKANA Family Reunion Promotion FeeIncludes the promotion evaluation and presentation in front of the AKANA Board of Directors and Advisors including 4 grandmasters who will be asked to sign the certified AKANA Promotion Certificate. Must test and be approved through your AKANA Dojo.

$100.00

Additional AKANA Family Reunion Tee Shirts Product Image

Additional AKANA Family Reunion Tee ShirtsFor additional shirts not included in the registration fee.

$30.00

	Quantity
Child
Small
Medium
Large
X-Large
XX-Large
XXX-Large

Item subtotal:$0.00

Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

2025 AKANA Family Reunion Payment Form