*PRE-REGISTRATION FEE **AFTER May 10, 2004 *ONE EVENT.........................$30.00 **$35.00
*TWO EVENTS......................$35.00 **$40.00
*THREE EVENTS..................$40.00 **$45.00
AIKA Members...THREE EVENTS.....$30.00 In Advance Or At The Door

WAIVER
I, the undersigned, waive all claims against any or all persons connected with the 2004 AIKA Isshinryu Karate Championships and training seminar, facility, Shihan Phillip R. Furgason, other competitors and medical personal for any injury that I may sustain during my participation in the Championships and/or Seminar(s). I have read the rules and agree to abide by them and assume full responsibility for any and all of my actions during and in connection with the AIKA Isshinryu Karate Championships and Seminar. I consent that any picture taken of me in connection with the Championships and Seminar may be used for publicity or promotion, and I waive compensation for the same.
Date______________ Contestant's Signature ________________________________________________
Legal Guardian or Parents Signature________________________________________________________
For Pre-registration please complete the form and return by May 10, 2004 to Shihan Phillip R. Furgason - AIKA Registration - 2319 North Durham Drive - Houston, TX 77008 (713) 863-0769

YOUTH DIVISIONS
1) 6-8 YEARS - PEE WEE
2) 9-11 YEARS - JUNIOR
3) 12-14 YEARS - TEEN A
4) 15-17 YEARS - TEEN B
5) 18-35 YEARS - ADULT DIVISIONS
6) MEN (A)BEGINNER (B) ADVANCED KATA
7) MEN (A) BEGINNER (B) ADVANCED KUMITE
8) WOMEN (A) BEGINNER (B) ADVANCED KATA
9) WOMEN (A) BEGINNER (B) ADVANCED KUMITE
10) MEN BLACK BELT KATA
11) MEN BLACK BELT KUMITE
12) WOMEN BLACK BELT KATA
13) WOMEN BLACK BELT KUMITE
14) 36 Years Old And Older AND OVER – EXECUTIVE
15) MEN (A)NOVICE (B)ADVANCED KATA
16) WOMEN (A)NOVICE (B)ADVANCED KUMITE

TRADITIONAL WEAPONS

17) AGES 11-14 (BROWN AND BLACK BELT
18) AGES 15-17 (BROWN AND BLACK BELT
19) ADULT MEN UNDER BLACK BELT
20) ADULT WOMEN UNDER BLACK BELT
21) BLACK BELT MEN
22) BLACK BELT WOMEN
23) EXECUTIVE BLACK BELT MEN
24) EXECUTIVE BLACK BELT WOMEN

FOR MORE INFORMATION CALL (832) 573-6836 OR E-MAIL: castrev1@yahoo.com

Hanshi William Washington will conduct a two hour seminar after the tournament.
March 30th - A two hour seminar will be conducted by Yon-Dan John Reese on May 30th followed by a three hour seminar by Shihan Phillip R. Furgason with thirty minute break between seminars. We will Schedule the time so all karate-ka will have ample warm up time before the seminar begins and end early enough for karate-ka to use the facilities to practice what they have learned.

Seminar Site: Salvation Army Boys and Girls Club 2600 Aldine Westfield – Houston, TX 77093 - Phone:(713)863-0769.

The Seminar site has showers and vending machines. There are fast food restaurants within two blocks of the site.

Accommodations - For a list of available hotels and motels please call 713-863-0769 or e-mail aika@swbell.net for more info. May 30, 2004

Registration Form WW/PF/JR1: $15.
The payment covers all three seminars.
Do not mail registrations after May 6, 2004.

Name____________________________________________________NO. of Adults______Other______
Address____________________________No. of People______x $15 =________
City/ST/Zip__________________________________________________________
Phone No(______)______________________Total Eclosed $________________
Please make check or money order payable to:
AIKA or Phillip R. Furgason
2319 North Durham Drive
Houston, Texas 77008