Membership Information

Contact Information

Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*
Date of Birth

Additional Family Members

For Family Memberships, please list all children under 23 years of age. Please include birthdates as well. 

Additional Family Members

Programs

Affiliation
  • Aikido
  • Ballroom
  • Board
  • Bonsai
  • Edgewood
  • Gakuen
  • Hula
  • JACL
  • Judo
  • Karate
  • Kendo
  • Kime komi
  • Kishin Daiko
  • Leisure Club
  • Matsu
  • Odori
  • Queen
  • Sabers
  • Singles
  • WCBT
  • Staff
  • Koto
  • Boomers
  • Volunteer

Payment Information

Amount*
$
Name on Card*
Card Number*
Additional Comments

Security Code