CCIKA Events

CCIKA Beach Training / Picnic

Select Event: *

Beach Training / Picnic - $10

Beach Training / Picnic Additional Attending

+ 1 person $10

+ 2 persons $20

+ 3 persons $30

+ 4 persons $40

First Name *

Last Name *

Gender *

Birth Date * +

Age *

Rank Level *

Email Address *

Student / Adult Contact

Relationship to Participants:

Parent/Gardian (under 18 yrs.)

Self (18 + yrs.)

Full Name

School / Dojo Information (if different from CCIKA)

School Name / Dojo *

Instructor

Address 1

City

State

Country

Phone

Email Address

Secured by Formsite