Western Regional Registration Form

Personal Information

Name*

First Last

Email

Phone

Are you a member of the Berkeley club?

Remember to enter coupon code BERKELEY at check-out, and you will receive a $10 discount.

Participation

What days will you be attending?

Saturday, October 13 (9:00am-4:30pm)
Sunday, October 14 (8:30am-12:00pm)

Cost for both days is $65 for a TAA member, $75 for non-member.

Which competitive events will you be participating in?

Tanto randori (mixed gender)
Koryu Dai San Enbu (all grades)
Ju Nana Hon Enbu (all grades)

If you are planning on doing competitive enbu, please write the name of your partner in the field(s) below. If you do not have a partner, we will do our best to pair you with someone before the event.

Ju Nana Hon Enbu Partner

Koryu Dai San Enbu Partner

Payment

Registration Type*

Total

$0.00

Cost includes a pizza lunch on Saturday.

Berkeley students receive $10 off their registration. Enter coupon code BERKELEY

Coupon

Credit Card

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Quantity

Please enter a value between 1 and 1.