Application Form for Open Category

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Application Form for Open Category


Japan Pole Sports Association (JPSA)


  ※ Who are applicants Open Category, Please apply from the following application form.
  ※ * Items marked is required fields.

■Division

*Division  Elite Senior Men +18 to 39
 Elite Senior Women +18 to 39
 Elite Doubles Men+18 to 39(Men&Men)
 Elite Doubles Women+18 to 39(Women&Women)
 Elite Doubles Mix+18 to 39(Men&Women)
 Elite Doubles Novice/Junior+10 to 17(Mix)
 Elite Junior Men+15 to 17
 Elite Junior Women+15 to 17
 Elite Novice Men+10 to 14
 Elite Novice Women+10 to 14
 Elite Master +40 Men
 Elite Master +40 Women
 Elite Master +50 Men
 Elite Master +50 Women
* Rehearsal date 1st choice of date:
2nd choice of date:
3rd choice of date:

※ Please understand that depending on your choice of date, it would not be avaialbe time.

■Applicant 1
※Please enter those who are entry single division here.
※Please enter the appliciacnt 1 of the doubles division here.
※Please enter your e-mail which attachments can be received address from jpsc2018@japanpolesports.org.
※If the applicant is a minor who is required fill in the name of parental authority.

* Full Name
* Sex  Male      Female
* Date of Birth Year   Month   Day  
* Age
* Country
* Zipcode
* Address
* Phone Number
* E-mail Address
Please enter your e-mail which attachments can be received address from jpsc2018@japanpolesports.org.
* Parental authority (in the case of minors)

■Applicant 2 (In the case of doubles)
※Please DO NOT enter those who are entry single division here.
※Please enter the appliciacnt 2 of the doubles division here.
※Please enter your e-mail which attachments can be received address from jpsc2018@japanpolesports.org.
※If the applicant is a minor who is required fill in the name of parental authority.

* Full Name
* Sex  Male      Female
* Date of Birth Year   Month   Day  
* Age
* Country
* Zipcode
* Address
* Phone Number
* E-mail Address
Please enter your e-mail which attachments can be received address from jpsc2018@japanpolesports.org.
* Parental authority (in the case of minors)

■Consent column
Those who apply to Japan Pole Sports OPEN Competition, Please confirm "Code of Points" and please agree to the regulations.

I agree to the Regulations.


      

Entry fee

※The deadline is Wednesday, January 31, 2018.

* Applicant of the doubles department is required entry fee by one person.
* Please make payment before transfer deadline.

Entry fee 11,000 JP Yen for athlete
7,000 JP Yen for coarch

Paypal
If you wish to pay by Paypal,
- Please click the below buttom.
- Please be the same name as the name that you fill out the application form tournament.


Entry fee for athlete
Select your category


Entry fee for coach
Coach entry fee is 7000JPY


The input confirmation fee of "Compulsory" and "Tech Bonus".
Confirmation fee is 600JPY


Bank transfer
If you wish to pay by bank transfer,
- Please be the same name as the name that you fill out the application form tournament.
- Please pay the transfer commission by the applicant.

Beneficiary Bank THE BANK OF TOKYO-MITSUBISHI UFJ, LTD.
Branch Name Tanimachi Branch
Account Number 019-0082398
Beneficiary Name Japan Pole Sports Association Masayo Okamoto