2009 Summer Camp Registration
for Washington Attendees
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2009 Summer Camp Registration for Washington Attendees
Your Name*
Rank*
10th Gup White Belt
9th Gup Yellow Belt
8th Gup Orange Belt
7th Gup Purple Belt
6th Gup Green Belt
5th Gup Green Belt
4th Gup Green Belt
3rd Gup Red Belt
2nd Gup Red Belt
1st Gup Red Belt
Cho Dan Bo
1st Dan
2nd Dan
3rd Dan
4th Dan
5th Dan
6th Dan
7th Dan
Gender*
Male
Female
Age*
Emergency Contact*
Phone*
Physician*
Phone*
Date of last Tetanus shot*
Can student swim?*
Yes
No
List of allergies
Dojang*
Bellevue
Burien
Snoqualmie
Yelm
Other
E-Mail Address*
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