Region 21

T-Shirt Registration

T-SHIRT ORDERS ARE CLOSED

First Name
Last Name
Association Number
Gender
Age
Rank
Studio
Instructor
Acknowledge Waiver

Tiger/dragon Registration

First Name
Last Name
Age
Studio
Rank
Acknowledge Waiver

regular registration

First Name
Last Name
Size
Studio

Saturday Night Beach party sign up


Pricing:


$25 for 1 person
$20 pp for 2 or more family members
$15 for children 5 - 10 years
No charge for children under 5


Number of Family Members
Name of Family Members

waiver acknowledgement


By applying online, I hereby waive and release any and all rights and claims against any persons, school, or associations connected with this clinic for any injuries or damages I may sustain, and will assume full responsibility for all my actions in connection with this clinic.  I agree and understand that any pictures taken of me or by me in connection with this clinic may be used by the tournament director (s) for publicity or promotion without compensation at this time or any other time.  


I will obey all required rules and regulations and assume full responsibility for all of my actions during and in connection with said clinic.

Please enter the appropriate information below to register for the 2016 Regional Clinic.Once you enter all of your information, Select "Add to Cart" which will bring you to the Pay Pal shopping cart. If you need to register another individual or purchase a T-Shirt (a T-shirt is NOT included with Clinic Registration), select "Continue Shopping".  Otherwise, select "Check Out"

2018 Region 21 Fall Clinic Registration

OCTOBER 5 - 7 , 2018