2026 Saeki Dojo Summer Camp
Registration Form

Participant Information

First name*

Last name*

Single choice*

Dojo Head Instructor

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. Otherwise, leave blank.

Kyu Exam

Dan Exam

Qualification Exam

BBQ

I will be attending the barbeque

Waiver

I acknowledge participating at my own risk and waive liabilities of all claims against Saeki Dojo and all its participants for personal injury or property damage resulting from participation in the 2026 Saeki Dojo Summer Camp held at the Saeki Dojo, 475 Cambridge Street South, Ottawa ON, K1S 4H6 from July 16 to July 19, 2026. I authorize any medical treatment deemed necessary by Saeki Dojo.

Name of parent/legal guardian, if under 18

Signature*

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2026 Saeki Dojo Summer Camp Registration Form

Participant Information

Program

Exam

BBQ

Waiver

2026 Saeki Dojo Summer Camp
Registration Form