JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
3 Week Trial Fight Gear Set Order Form
Gear set includes: Head, Hands, Feet, Mouth Guard, Dojo Custom Gear Bucket Bag and Groin Cup (male) or Isshinryu Patch (female). Please indicate sizes for Head, Hands & Feet
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Student Name
*
Your answer
Age
*
Your answer
Class
*
Choose
Little Dragons (5-8 yrs)
Jaguars (9-13 yrs)
Teen/Adult (14 & Up)
Which dojo would you like to pickup your order from?
*
Choose
Pure Karate Rockaway
Headquarters/Landing
Annex/Randolph
Color
*
Choose
Red (normally in stock)
Black (Brown or Black Belts only: special order)
Purple (special order)
White (Black Belts only: special order)
Pink (special order)
Head Gear (Child & Adult $44.95)
*
Choose
Adult Small
Adult Medium
Adult Large
Adult X-Large
None
Hand Gear (Child & Adult $44.95)
*
Choose
Child
Small
Medium
Large
XLarge
None
Foot Gear (Child & Adult $44.95)
*
Choose
1/2
3/4
5/6
7/7.5
8/8.5
9/10
11/12
13/14
None
Groin Cup & Supporter (Male) Isshinryu Patch (Female) (Child & Adult $14.95)
*
Choose
Adult Small
Adult Medium
Adult Large
Adult X-Large
None
Dojo Custom Gear Bag (Color selection as available $55.95)
*
Choose
Blue
Black
I agree to pay in full before order is place using the default payment method on file.
*
Yes
No
Required
Parent/Guardian Name (Student if over 18)
*
Your answer
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
