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36th Annual U of M Karate Tournament Registration Form- Youth
February 25, 2023
University Rec Well Center | 123 SE Harvard St Minneapolis
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Participant Information
Participant Name ( First and Last Name )
*
Your answer
Participant Phone Number
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Age at Time of Event
*
Your answer
Gender
*
Female
Male
Prefer not to say
Other:
Dojo/Style/System
*
Your answer
Rank
*
10th kyu (White Belt)
9th kyu
8th kyu
7th kyu
6th kyu
5th kyu
4th kyu
3rd kyu
2nd kyu
1st kyu
Black Belt
Other:
Medications, Allergies, Injuries, Sensitivities, and Medical Issues (if any)
Your answer
Parent/Guardian- Name, Email, Phone Number
*
Your answer
Additional Emergency Contact- Name, Relationship, Contact Phone Number
We will contact Parent/Guardian first
Your answer
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