Hanshi Seifuku Nitta - Okinawa Shorin RyuHanshi Lohhny Lupton- Jiu-Jitsu IrelandHanshi Peter Carbone- Okinawa Kobudo

Sensei Kimo Robello- Hawaii KenpoSensei John Ross - Goju-Kan AustraliaSensei Eric Marn - Hawaii Shotokan

Garry Parker - Georgia Goshukan

29 June - 7 July

Seminar Registration Form

NAME: SCHOOL:

ADDRESS: ADDRESS:

City State Zip Code City State Zip Code

PHONE: ( ) - FAX: ( ) - INSTRUCTOR:

AGE: GENDER: YRS EXP: yrs. mths PHONE: ( ) - FAX: ( ) -

e-MAIL: e-MAIL:

Friday June 12th 2009 Danita Clarke:

Hakutsuru 6pm to 9pm (UMAA Life Members Only) Camp Hotel: Quality Inn 400 US Hwy 70 West Havelock, NC 28532 Phone: (252) 444-1111 Monday June 15th 2009 Hanshi Tony Sandoval Kyoshi Danita Clarke

Hakutsuru 9am to 2pm ($30 Additional Seminar Fee) White Crane Testing Available

Saturday June 13th 2009 Group A Don Dike:

Kuda Kama Sho 9:00am to 10:30pm Tony Sandoval:

Kata Bunkai 10:45am to 12:15am Lunch:

12:15pm to 1:30pm Jann Aki:

Escrima 1:30pm to 3:00pm 2008 Camp Review Part I:

Nitan Bo/Chinto 3:00pm to 4:00pm Kama & Nitan Bo/Escrima Sticks Required

Sunday June 14th 2009 Group B Ken Morgan:

Naihachi Concepts 9:00am to 10:30am Scot Mertz:

Kuniyoshi Timbe 10:45am to12:15pm Lunch:

12:15pm to 1:30pm Troy Price:

Chi Na 1:30pm to 3:00pm 2008 Camp Review Part II:

Sohcin/Irei Eku 3:00pm to 4:00pm Timbe & Eku Required

I agree to the terms of this waiver of liability for the 2009 UMAA Summer Camp.

I am in very good health and desire to participate in this Summer Camp and subsequent seminars. I am solely responsible for all medical fees in case of injury or death during or after these seminars. I agree to hold harmless the Universal Martial Arts Association, Family Karate Center, Inc., guest instructors, or their associates.

Signature (Parent/Guardian if under18):

(electronic version shall be signed at registration.)

REGISTRATION FEE: $150.00 PLEASE MAIL FORM WITH CHECK OR MONEY ORDER MADE PAYABLE TO: Frank Williams 119 Longwood Drive, Stella, NC 28582 (includes all Sat/Sun Seminars)

Payment Method: VISA MasterCard Checks Money Order

Life Members Receive 20% discount

$

Card Owner Name: Monday Hakutsuru Seminar $30 $

Credit Card #: TOTAL: $

Expiration Date: / Signature:

Any questions? Just call: Phone: (910) 546-4144 Fax: (252) 447-2446 e-Mail: ryujikan@yahoo.com

FOR OFFICE USE ONLY

DATE POSTMARKED________________ AMOUNT____________ ⃞CASH CHECK #__________ RECEIVED BY: ______

Friday July 1- Hibiscus Room #2

Hawaii Kempo

Shorin-Ryu Karate & KobudoJohn Ross:

Goju-Kan Australia

Saturday July 2 - Hibiscus Room #2(9am-5pm)Eric Marn: Hawaii KempoGarry Parker: GoshukanJohn Lupton: Ireland Jujitsu

Wednesday June 29Check into hotel (Free Day)

Thursday June 30 - I'lima Room

(9am-5pm)Kimo Robello:

Frank Williams:

Welcome: Introductions Refreshments Seminar, T-shirt and tour packet pick-up

Goju-kan's Black Belt grading @ the Kaneohe hombu dojo. (all are welcomed to watch) TBA

Sunday July 3 - Hibiscus Room #2(8am - 12 noon)Swap Meet/Flee Market shopping (1pm - 5pm) Charles Goodin: Hawaii Shorin-RyuSeifuku Nitta: Okinawa Shorin-RyuFarewell Gathering(6pm - 9pm) - I'lima Room

2011

Celebration Fireworks show

Monday July 4 - Moana Beach Park

Tuesday July 5(8am-1pm) Pearl Harbor Tour

Wednesday July 6(1pm-8pm) Paradise Cove Hawaiian Dinner & Show

Seminar Fee (per day) $75.00 each X____days $

add 125.00 second family member$100.00 every family member thereafter

Entertainment Package tour Events

Age 12 & older - $18.00 each X ___=$_____Age 5-11 - $12.00 each X ___=$______Age 4 & under FREE

*Pearl Harbor *Hawaiian Dinner & Show *Swap Meet/Flee Market *Celebration Fireworks Show

Entire Tour package at $200.00 per person $175.00 per each family member thereafter

ONE FREE T-SHIRTQTY & SIZES: ____ YS / ____ YM / ____ YL / ____ AS / ____ AM / ____AL / ____ AXL*Add $2.00 more for each T-Shirt(s) of XXL or larger sizes. Additional Gasshuku T-shirt @ $10.00 each x _____ = $_____________

$175.00 per each family member thereafterFarewell Gathering

1-808-741-3420 1-808-837-3637 theakis1@aol.com or jann.aki@dfs.com

Jann K. Aki44-252 Mikiola Drive Kaneohe, Hawaii 96744 USA

United Goju-Kan Karate-do

I

Order

Entertainment Tour Package

(includes fri/sat/sun seminars)$150 each per person