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Building Sk‚Äčills for Life 

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Champions Challenge

Date: March 4th, 2023

Registration at the door starts at 8:00 am

Continuous Sparring and Team Forms start at 9:00 am

(continuous competitors MUST be pre registered by 8:30am and at their rings at 9:00am or risk not competing) 

Forms/Weapons/Point Sparring will start at 10:00 am

Lapeer High School 933 S. Saginaw St. Lapeer MI. 48446

Two Ways To Pay!

ONLINE VIA PAYPAL (Competitors only)

$60 flat rate for competitors that pay ONLINE for ALL divisions

Please select how many competitors and proceed with payment, you will receive a confirmation email from [email protected]

(Please allow 24-48 hours for confirmation email of payment received. Thank you)


Champions Challenge Competitor Pre-Registration
$60.00


OR Send In Registration form!


Please print and fill out registration form below and mail to:


Dragon Karate 1624 N. Saginaw St., Lapeer MI. 48446


(Competitors and spectators may send registration in via mail)


Please Make Checks Payable to:


Dragon Karate


Cost:

Competitors Pre-Registration: $60 for 3 divisions and $5 for ea. Additional Division

Spectators Pre-Registration: $8

Competitors at the door: $65 for 1st even and $5 for ea. Additional Division

Spectators at the door: $10


PAYMENTS ARE NON- Refundable and Cash Only will be accepted at the DOOR!


CHAMPIONS CHALLENGE


Competitors Pre-Registration: $60 for 3 divisions and $5 for ea. Additional Division

Spectators Pre-Registration: $8

Competitors at the door: $65 for 1st even and $5 for ea. Additional Division

Spectators at the door: $10



NAME:_______________________________________________________


AGE:___________


ADDRESS:____________________________________________________


CITY:_______________ STATE:______ ZIP:_____________


PHONE:_______________________________


EMAIL: ________________________________________________


BELT LEVEL_____________________________________


SCHOOL:_____________________________________


                               DIVISIONS:


Black Belt                                                Under Belt:


Team forms _____

Open Forms_____                           Open/Trad Forms____

Open Weapons ____                       Open/Trad Weapons____

Traditional Forms _____                  Point Sparring _____

Traditional Weapons _____


Continuous Sparring ______

Point Sparring ______


Spectators (how many?)___________


Waiver of Release Liability: I hereby assume all risk for Champions Challenge and hereby release the tournament directors, Dan Cousineau, Dragon Karate LLC, and Lapeer High School for all personal injuries known or unknown which the competitors may incur in the tournament. I understand that tournaments involve significant and substantial physical contact between participants and the competitors may receive injuries as a result. I have read and understand this release and all of its items. I voluntarily execute it; with full knowledge of its significance.

Competitor Signature (parent/ guardian if under 18)

___________________________________________________

Date _____________