2024 Shintani Symposium REGISTRATION
Date: Friday July 12th 6:00pm - Sunday July 14th 12:00pm (BONUS DAY: Thursday July 11th arrival 5:00pm)
Island Ferry Dock Address: Island Spirits, 86 Rolling Banks Road, Roseneath, ON  K0K 2X0
Contact us at: shintanisymposium@gmail.com 
Sign in to Google to save your progress. Learn more
PERSONAL INFORMATION (one form per household with same contact info and emergency contacts)
First and Last Name (primary responsible adult, must be over 18)  *
Age  *
Email Address *
Phone Number *
Home Dojo/Club and Location (or home location for non-karate participant) *
Emergency Contact Name and Phone number
 *
Alternate Emergency Contact Name and Phone Number
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms