2017 BUSHIKAN PARENTS NIGHT OUT


* Name:
* Last Name:

* Address:

* City: * State:

* Zip Code:

* Home Phone #: * Cell Phone #:

* E-mail:

NIGHT 1: February 11, 2017
NIGHT 2: April 22, 2017
NIGHT 3: June 17, 2017
NIGHT 4: August 19 , 2017
NIGHT 5: October 28 , 2017
NIGHT 6: December 16 , 2017

FEES PER PNO

PNO: 5:00 pm ~ 9:00 pm: $30 Each

PNO Fees: $30.00

Total Amount :

Method of Payment: Check by Mail: Credit Card :

Illness/Injuries?

* Emergency Contact:

* Emergency Contact Phone:

* If you are paying by credit card we will call you to obtain your
information and confirm your registration.

 

 

   
   
   
   
   
   
   
   
   
     
e-mail: fs@bushikan.com
1945 S. Rancho Santa Fe Rd. #D
San Marcos, CA 92078 - USA
Phone:
(760) 744-5560
 
  Copyright © 2003~2017
Bushikan Budo Kyokai

Matayoshi Kobudo Kodokan Intl.

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or photos without our permission