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First Name

Last Name

Membership Number

Date of Birth

Age

Gender

Cell Phone Number

Email Address

Facebook/Messenger Username

Mailing Street Address

City

State

Zip Code

Belt Rank

Weight (in kilograms)

Which tournament did you qualify for worlds at? If you participated in 2025 Worlds please state "2025 ICO Participant".

Karate School

Primary Instructor

Divisions (Which events are you planning to participate in during Worlds?)

ICO Full Contact ICO Kick Light (Low Kick) ICO Point Fighting ICO Blitz Fighting (Hands Only) ICO Open Weight ICO Ring Continuous ICO K1 Full Contact ICO Muay Thai ICO K1 Continuous ICO Martial Box Light ICO Mat Light Continuous ICO Substrike MMA Traditional Forms Creative Forms Japanese Forms Soft Style Forms Traditional Weapons Creative Weapons Korean Forms Freestyle Forms Freestyle Weapons Grappling Gi Grappling No Gi Combat Jujitsu Full Contact Karate (Kyokushin) Team Sync Forms Team Sync Weapons Team Demo Team Fighting Kumite

T-shirt Size

Emergency Contact Name

Your Relation to the Emergency Contact (i.e., spouse, parent, etc)

Emergency Contact Cell Phone

Any medical conditions or consideration?

Contact Us

General Information - 404 734 7194
icoamerica26@gmail.com