The Dojang Korean Martial Arts Academy, LLC

Transported After School Karate • 505 Santa Fe Trail • Ellenwood, Georgia 30294
(770) 389 – 4411 • mojakwan@gmail.com

Region 21 Leadership Team

Re: Fall Summer Camp

March 1, 2010

Dear Sir/Madam,

I am honored to be your host for this year’s Leadership Camp for Cho Dan Bos and Dans in
Region 21. This year we will return to the beautiful FFA Camp in Covington, Georgia
(www.GeorgiaFFACamp.org). The registration fee is inclusive of lodging and meals. If you have
special food needs please tell me on the registration form and register early. I know most of you
have already taken care of your 2010 Region 21 dues. As with past years, a non Dan parent may
attend at the full fee $100.00. I will be publishing the final schedule in October and forwarding to
your instructor.

Once all registrations are received we will make cabin assignments. If you are an adult and would
like to volunteer as a cabin leader please make note on your registration. I do not know the exact
head count yet, but we intend to be organized into 4 cabins male and female, youth and adult. The
beds are barracks style twin size bunk beds.

Here is a suggested packing list;

□ Twin size bedding (can be rented from FFA for around $10-$15)
□ Your pillow if you need it to sleep
□ Toiletries
□ Cheap flip flops (for community shower)
□ Sneakers for outdoor training and recreation
□ Dobok with all Association patches
□ Belt
□ Sparring Gear (Head, Hands, Boots, Mouthpiece and cup for males)
□ Staff
□ Practice Dagger
□ Sword – Dans

Respectfully Submitted,

Charles Richards
Charles Richards
WTSDA#23720
www.thedojang.info
 Region #21 Blackbelt Camp
October 22-24, 2010
Georgia FFA-FCCLA Center
720 FFA-FHA Camp Road
Covington, Georgia 30014
www.georgiaffacamp.org

Deadline: Early online by 9/15/10

Online by 10/15/10
Mail in by 9/30/10
(No Door or Last minute Entries)
All participants must be pre-registered!

Equipment: Gups & Dan - Headgear, hand & footgear, mouthpiece, and groin cup
Staff, Practice dagger, sword (E-Dan and up), toiletries and bed linens.
------------------------------------------------------------------------------------------------------------------------------------
Entry Information:

Name:______________________________ __________
Association No.________ _________ M/F Age:_ __
Dojang:______________________ __________ Instructor:___________________________ _____
Food allergies/requests

Rank: Fees:
□ Cho Dan Bo □ Online by 9/15/10 $100
□ Cho Dan □ Online 9/16/10 through 10/15/10 $110
□ E Dan □ Mail in postmarked by 9/30/10 $100
□ Sam Dan
□ Sah Dan
□ Presenter (contact mojakwan@gmail.com for exact fee)
□ Accompanying guardian for
I, the undersigned, for myself, my heirs, executors and administrators, do hereby waive, release and forever discharge any and all rights and claims for damages which I may
have or officers, representatives, successors, officers of the Camp, my own studio, my own instructor, FFA, and/or assignee against any competitors for any and all damages
which maybe sustained by me.

I will obey all rules and regulations and also assume full responsibility for all of my actions during and in connection with said Camp.

Signature: ___________________________ Parent (if under 18):_____________________________

I, verify the applicant is a student in good standing at my studio and that the above information is correct.

Instructor Sign: ____________________________________ Date: ____________________________

Check payable to: Region 21 Black Belt Club T-Shirt Size Qty Total
Ch M
Mail To: The Dojang KMAA, LLC Ch L
505 Santa Fe Trail. Adult S
Ellenwood, Georgia 30294 Adult M
Register online at: Adult L
http://www.thedojangkmaa.blogspot.com/ Adult XL
Adult XXL
Total Fee $