AJKA – International/USA

S H O T O K A NS H O T O K A N S E M I N A R SS E M I N A R S

Sunday, January 28, 2018 Hosted by Sensei Amy Hung – RSK Orange Terrace

1760 Chicago Ave, Suite J9 – Riverside, CA 92507

Sensei Edmond Otis - 8th dan (AJKA-I North America & Australasia Chief Instructor)

Seminar Schedule

Youth Seminar 10:00am - 11:20am

Competition Seminar 11:30am - 1:00pm

Adults Seminar 1:10pm - 2:30pm

Seminar Fees AJKA-I Members - $60 for 2 seminars $45 for Single Seminar Non-Members - $80 for 2 seminars $60 for Single Seminar

Please Make checks Payable To: AJKA-I CASH ONLY AT THE DOOR

“Karate should only be challenging on the floor.” Non-political - all are welcome!

WRITE: AJKAUSA@ GMAIL.COM CALL: 909.275.0558

VISIT: www.AJKAI-USA.com

2018 SHOTOKAN SEMINAR REGISTRATION FORM

2018 RIVERSIDE SHOTOKAN KARATE SEMINAR January 28, 2018

Name: ___________________________________________ Age: __________ Address: ______________________________________________________________________________ City: _________________________ State: __________ Zip: __________________ Dojo: __________________________________________ Instructor: __________________________________ Rank: __________

Events Located at 1760 Chicago Ave Suite J9 – Riverside, CA 92507 ____ Youth Seminar: 11:00am-11:20am ____ Competition Seminar: 11:30am-1:00pm ____ Adult Seminar: 1:10-2:30pm AJKA-I Members: $45 per seminar / $60 for access to 2 seminars Non-members: $60 per seminar / $80 for access to 2 seminars Total $: __________________ (CASH is preferable; ALL event day registrations MUST BE CASH)

Please make checks payable to – “AJKA-I” Mail Registration to: AJKA-I : 1242 University Ave BOX 570 – Riverside, CA 92507 I, the undersigned, do voluntarily submit my application for participation and attendance in the Essential Shotokan Seminar Series, Saturday, January 28, 2017, and do hereby release all rights or claims for any injuries, loss or damage which I may have against Riverside Karate Club, the AJKA-I, and any other sponsors. This includes all individuals assisting in arranging and conducting this seminar and any of their agents, representatives, successors, and assignees for any and all injuries, loss or damage incurred by me at this seminar or in any way connected with this seminar, it’s participants, and personnel or the premises on which it is held. I acknowledge that any photographs furnished by me or any photographs taken of me in connection with this tournament may be used for publicity, promotion, television or other public display, and waive compensation in regard thereto. ________________________________________________ DATE______________ Signature of Participant ________________________________________________ DATE______________ Signature of Participant/Guardian (if participant is under 18 yrs. of age