2012 All-Star Karate League (ASKL)

NO MEMBERSHIP REGISTRATION AFTER SEPTEMBER 1, 2012!

Competitors Name:	Telephone # (NPA-NXX-XXXX):

Address:	City:

State:	Zip Code:

Competitors Age:	Competitors DOB (MM/DD/YY):

Competitors Email:	Competitors Rank:

Individual:	Team:

2011 ASKL T-Shirt

Name on Credit Card:	Credit Card Type:

Credit Card Number:	Expiration Date:

USE THE CALCULATOR BELOW TO ENTER TOTAL!
Total:
Comments:
I Agree to pay the total amount as a non-refundable charge to my credit card and I agree that it cannot be charged back or cancelled without the express written consent of the ASKL.

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