2025 OJKA Canada Koyo Camp Registration Form

Participant Information

First name*

Last name*

Single choice*

Dojo Instructor

Student

Date of Birth*

Year

Month

Day

Email*

Phone*

Address*

City*

Postal Code*

Province/State*

Country*

Dojo name*

Ottawa JKA Canada Affiliate

Current Rank*

Program

Please, select the appropriate program

Instructors Program

Adults Program

Youth Program

Exam

Please, fill in this section only if you will be grading at the camp.

Kyu Exam

Dan Exam

Qualification Exam

Celebratory Dinner

I will be attending the dinner

Waiver

I acknowledge participating at my own risk and waive liabilities of all claims against Ottawa JKA and all its participants for personal injury or property damage resulting from participation in the 2025 OJKA Canada Koyo Camp held at the Saeki Dojo, 475 Cambridge Street South, Ottawa ON, K1S 4H6 from November 20 to November 23, 2025. I authorize any medical treatment deemed necessary by Ottawa JKA.

Name of parent/legal guardian, if under 18

Signature*

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