Individual Registration

Please enter information in the form below to process registration for event National competitive dan grading for seniors and veterans.

Email *

First Name *

Last Name *

Date of Birth (dd/mm/yyyy)

Licence *

Club *

Area

Approx actual weight (Kg) *

Sex *

Which grading? *

Current points total

Theory done?

Yes

Would you like to do your theory exam at this event?

Yes

Age on day of competition *

Your CURRENT grade *

Amount

Payment Method

Paypal

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Holder Name*

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