New Wave 2008 Winter Invitational

NEW WAVE SELF-DEFENSE

2008 WINTER INVITATIONAL - REGISTRATION FORM

*** EARLY BIRD SPECIAL ***

Register by Saturday, November 22^nd...

$30 per person - 1^st event ... ... $5 each additional event

After Saturday, November 22^nd...

$40 per person - 1^st event ... ... $5 each additional event

First Name:

Last Name:

Address:

City:

State: Zip:

Phone:

999-999-9999

E-mail:

Age:

Rank:

Height:

ft/in

Weight: lbs

Instructor:

Dojo:

Dojo Phone: 999-999-9999

Please select the divisions that you will participate in:

	Forms
	Capoeira
	Breaking
	Sparring
	Weapons