Registration Form 2019 U.S. Kungfu Team Trials Sunday March 10, 2019 U.S. citizens or permanent residents only – must be current member of USAWKF Important Registration Policies – Please read carefully! 1. Please read “ 2019 US Kung Fu Team Trials” and understand all terms and conditions. 2. All registration forms must be filled out completely and accurately. Both email address and phone number are required 3. Please note that all registration and event fees are non – refundable 4. Any returned check will be assessed with fee of $35 _______________ ________________ ___________________ ________________ First Name Last name USAWKF Member # Birthday (mm/dd/yyyy) _______________ ________________ ___________________________________________ Email Phone School Please complete the following steps and calculate your fees accordingly. 1. Gender Male Female 2. Age Group ( Please check one) Group A: below age 12 (born on or after January 1, 2008) G Group B: age 12-17 (born between January 1, 2002 and December 31, 2007) r G Group C: age 18-39 (born between January 1, 1980 and December 31, 2001) Group D: age 40-59 (born between January 1, 1960 and December 31, 1979) Group E: age 60 and above (born on or before December 31, 1959) 3. Events: Taijiquan Style Chen Yang Sun Compulsory 42-form Other Traditional Taijiquan Nanquan Style Yongchunquan Wuzuquan Cailifo Huheshuangxing Dishuquan Other Nanquan Styles Other Quanshu XIngyiquan Baguazhang Bajiquan Tongbeiquan Piguaquan Fanziquan Ditangquan Hongquan Chaquan Huaquan 花拳 Paoquan Xiangxingquan Huaquan 华拳 Shaolinquan Wudangquan Emeiquan Other traditional Quanshus Single Weapon Broadsword Sword Staff Spear Pudao Taijijian (incl 42-form Taijijian) Dagger Whip Walking Stick (Zhang) Club (Guai) Shovel (Chan) Fork Fan Taijidao Taijiqiang Nandao Nangun Other traditional apparatus Double Weapons Double Broadswords Double Swords Double Whips Double Hooks Double Daggers Double Axes Other Traditional Double Weapons Soft Weapon Nine-Section Whip Two-section staff Meteor Hammer (Liuxingchui) Rope dart Other traditional soft weapons 4. Fees: Registration fee ($30 before or on March 10, 2019) =$_________ ____ Events x$20 =$_________ Total: =$_________ 5. Payment method ( Check or Money order ): Please make your check or money order payable to Omei Academy 6. Mail Payment, completed registration and waiver forms to: Omei Academy, 10070 Imperial Ave., Cupertino, CA 95014. Please reference participant’s name on the check. .