Register

ON-LINE REGISTRATION & PAYMENT

Competitor Registration & Release

Please fill out the form completely. Early registration and fully completed forms help us achieve our goal of ensuring a safe, enjoyable and “on-time” competition and experience for the participants, their families & friends. If you have any questions please ask your instructor for help. Additional family members registering for the tournament must each fill out this form. Team Form members must each be registered in individual events. Be sure to use the SQUARE STORE link at the bottom of this page to pay for and complete your registration.
Register by August 10th, 2013 to take advantage of the early registration discount.

Name *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Age *

Weight *

Gender *

Male Female

Belt *

Instructors Name *

Forms Code (F-1 thru -31) *

Weapons Code (W-1 thru -13) *

Rank *

School Name / Dojang *

Sparring Code (S-1 thru -31) *

Team Forms Code (TF-1 thru -3) *

Comment *

Waiver of Claim: I hereby submit my application for registration in the USGTSDA West Coast Championships on August 23 – 24, 2013. I agree to waive all claims against any persons, school, or association connected with the Championships, including OCKicks, Inc. the USGTSDA and the Anaheim Hilton Hotel. I assume complete and full responsibility for any injuries I may sustain, and likewise will assume full responsibility for all my actions in connection with the Championships. I understand further that I will strictly observe and obey the rules and regulations governing the Championships.

Submit

Upon completing your registration form proceed to our SQUARE store to pay your competitor fees.