CAPOEIRA BRASIL LOS ANGELES

COMPRANDO O JOGO Registration

Thursday Feb 18 - Monday Feb 22, Los Angeles

First name
 Last name
 Nickname (optional)
Under 18? Yes
if yes, list age 		M/F?
Female | Male 		 
 
Group: CBLA | CB | Other    If other, group name
City (where you train)
 Cord color
 Your Instructor's name
Are you an instructor?
Yes 		 
 
Contact info
Email
 Phone
 Mail Address
Payment method
Check | Cash | Paypal
  		T-shirt Size
Out of town travelers only
Arrival (Month/Day)
 Time (PT)
Departure (Month/Day)
 Time (PT)
Arriving by
Car | Train| Plane, Flight 		Need Housing?
Yes | No
Special Notes (e.g. allergies?, travelling with other people?)

5557 WASHINGTON BLVD, CA 90016    323.935.2224