Annual Intensive Registration Form

Where are you coming from?(Required)

State, Country

What are the travel recommended guidelines coming from your country into NY, USA?(Required)

Student Membership Expiration Date (Please enter LIFE if you're a life member)(Required)

Format: DD/MM/YY

Instructor License Expiration Date(Required)

Format: DD/MM/YY Please enter "N/A" if not applicable

Name of your instructor

Accommodation

Feel free to contact the hotel directly to book your room under the Martial Art rooming block. If you wish to share room, please do not book your own room. Contact us and we will try our best to help you arrange for a roommate.

Please let us know the names of your roommates, if you have already arranged on your own.

Please help us get a better understanding of how many rooms we need from the hotel.

Sharing Rooms

To help us coordinate the rooms and to find you a roommate, please let us know if you're fully vaccinated or not. Some people may only be comfortable rooming with those who are fully vaccinated.

Check in date:(Required)

Date you plan on arriving to the hotel. MM/DD/YYY

Check out date:(Required)

Date you plan on departing the hotel. MM/DD/YYY

Travel

Please tell us your travel plans so we could better assist you with transportation if necessary

What is your flight # and airline?

Private Lessons

Additional lessons are only available AFTER the intensive, please let us know if you're interested in staying to train at Master Sam Chin's residence the week after the intensive

You're almost done...

Name of spouse or family member

Relationship to participant

Emergency Contact

Please let us know who to contact in the rare case of emergency

Relationship to participant(Required)

phone Number(Required)

Are there any health related issues that we should know about you?

Miscellaneous

Anything else you'd like to share with us?

Name

This field is for validation purposes and should be left unchanged.

Intensive Registration

Grading Levels