Don't Miss The Opportunity to Train with One of the World's Best, 9th Dan, Hanshi R. Johns, on the Beautiful Beaches and More in the Country of Panama!

1. Camp Panamá 2013
High level competition
27th International Camp & Championship
March 10 – 17, 2013
Enjoy the Beautiful Country of Panamá
All ages
International Instructor
Hanshi Ricardo W Johns
9th Dan
The Most Dynamic and Technical Camp
The Most Innovative Applications of Katas
Special Kumite Training for Competition
Judges and Referees Workshop
Professionally Organized Tournaments High Dan participation
High Level Tournament Officials
281-499-1313
dskaj@msn.com
347-327-4421 832-715-8341
eejlowe@aol.com alexg1105@gmail.com
WWW.DSKA.ORG

2. << Dai-Ichi Shotokan Karate-Do >>
Spring Camp/Tournament
10th – 17th March 2013
PANAMA CITY, PANAMA
Come and enjoy Panama!! Enjoy the sights of Panama and its exciting, shopping, and dining places. Discover
the wonder of the Panama Canal and witness history in making with the work being done to expand the canal.
Enjoy the sights of old Panama and its history, Palacio de las Garzas the official residence of the President of
Panama. Enjoy shopping at the malls, spend 2 nights 3 days at an all-inclusive beach resort and much more!
Paradise is found!
8 day / 7 night packages start from
$360-$650
Packages Include:
• Camp Fee
• Transportation
• 2 nights/3 days all inclusive beach resort
• Tours
• Farewell Banquet
Conditions: Prices subject to change. Prices include taxes. First deposit October 1, 2012. Final Balance is due 30 days prior to departure.
Recommendations: Reserve Early!
For information contact: Shihan Kareemah Johns
Please note airfare and 5nights stay at Torres de Alba Hotel in Panama City not included
281-499-1313
E-mail dskaj@msn.com, dski.membership@gmail.com

3. SPRING CAMP PANAMA 2013
PACKAGES
Package # 1- Adult (12 and above) Package # 2- Children (5 thru 11)
Participants Participants
This Package Includes the Following: This Package Includes the Following:
Transportation Fee: Transportation Fee:
• To and From Tocumen International Airport • To and From Tocumen International Airport
• To and From Decameron all Inclusive resort • To and From Decameron all Inclusive resort
• To and From Tournament • To and From Tournament
• All Tours, Etc. • All Tours, Etc.
Training Camp 2013 Fee Training Camp 2013 Fee
2 nights 3 days Decameron all Inclusive resort 2 nights 3 days Decameron all Inclusive resort
DSKA closing cultural banquet DSKA closing cultural banquet
Total $650.00 per Person Total $540.00 per Person
Does not include airfare or Torres de Alba hotel fees Does not include airfare or Torres de Alba hotel fees
Package # 4- Children (5 thru 11)
Package # 3- Adult (12 and above) Non-Participants
Non Participants This Package Includes the Following:
This Package Includes the Following:
Transportation Fee:
Transportation Fee: • To and From Tocumen International Airport
• To and From Tocumen International Airport • To and From Decameron all Inclusive resort
• To and From Decameron all Inclusive resort • To and From Tournament
• To and From Tournament • All Tours, Etc.
• All Tours, Etc. 2 nights 3 days Decameron all Inclusive resort
2 nights 3 days Decameron all Inclusive resort DSKA closing cultural banquet
DSKA closing cultural banquet
Total $360.00 per Person
Total $490.00 per Person Does not include airfare or Torres de Alba hotel fees
Does not include airfare or Torres de Alba hotel fees

4.
SPRING CAMP 2013
PANAMA
REGISTRATION
Thank you for registering to attend the Dai‐Ichi Spring Camp and Tournament. We want to make the process as easy as
possible. You will need to complete a separate registration form for each individual attending.
If you have any questions about registration, please call 281‐499‐1313 or 713‐478‐9051.
Full Name
First Name
Last Name
Address
Street Address
Address Line 2
City
State
Postal Zip Code
Phone Number
E‐Mail
Date of Birth
Nationality

5.
SPRING CAMP REGISTRATION
PACKAGE INFORMATION
Please select the type of registration (s) you would like. (Please note that package is per person)
o Package # 1‐ Adult (12 and above) Camp Participant $650.00
o Package #2 – Child (5 thru 11) Camp Participant $540.00
o Package #3 – Adult (12 and above) Family member/Guest $490.00
o Package #4 – Child (5 thru 11) Family member/Guest $360.00
Resort Information
Please list all names and ages of all persons rooming with you
Name__________________________________________________ Age________
Name__________________________________________________ Age________
Name__________________________________________________ Age________
Name__________________________________________________ Age________
Hotel Information
Hotel Torres De Alba Check‐in date 03/12/2013
Rate: $99.00/per night double occupancy (breakfast and tax included)
Number of persons in room ________
Name of person responsible for credit card payment
Credit card number
Passport number
Deposit Information
Note: Your credit card will not be charged. Once you check‐in to the hotel you will be responsible for payment at that
time.
Page 2

6.
Spring Camp Registration cont.
PAYMENT PLAN
Package #1
Payment Number Due Date Amount
1 10/01/2012 $130.00
2 11/01/2012 $130.00
3 12/01/2012 $130.00
4 01/01/2013 $130.00
5 02/01/2013 $130.00
Package #2
Payment Number Due Date Amount
1 10/01/2012 $108.00
2 11/01/2012 $108.00
3 12/01/2012 $108.00
4 01/01/2013 $108.00
5 02/01/2013 $108.00
Package #3
Payment Number Due Date Amount Due
1 10/01/2012 $80.00
2 11/01/2012 $80.00
3 12/01/2012 $80.00
4 01/01/2013 $80.00
5 02/01/2013 $80.00
Package #4
Package Number Due Date Amount Due
1 10/01/2012 $72.00
2 11/01/2012 $72.00
3 12/01/2012 $72.00
4 01/01/2013 $72.00
5 02/01/2013 $72.00
Note: Package does not include hotel and airfare. All hotel reservations must be done through Dai‐Ichi Shotokan
Karate‐Do camp coordinator in order to receive special rate. Once we receive your registration form we will contact
the hotel and reserve your room. Once you get to the hotel you will make your payment.
Please return pages 1& 2 with your payment
Please make payments to DAI‐ICHI, 2435‐G Texas Parkway, Missouri City, TX 77489
Methods of Payments Cash, Certified Checks or Money Orders, Please No personal Checks.
Page 3

7. DAI-ICHI SHOTOKAN KARATE-DO ASSOCIATION
Panama Spring Camp 2013
Medical History& Waiver
Name: (Please print) _____________________________________ DOB: _________________
Personal Physician: _____________________________ Office Number: ______________________
• Please complete all questions, if you have any condition that is not listed please indicate at the bottom.
Explain all “yes” answers below:
Yes No
1. Have you ever been hospitalized? [ ] [ ]
2. Have you ever had any type of surgeries? [ ] [ ]
3. Are you taking any medications? [ ] [ ]
4. Do you have any allergies to (bees, medicines, plants, or other insects)? [ ] [ ]
5. Have you ever or presently have high blood pressure? [ ] [ ]
6. Have you ever passed out during or after exercises? [ ] [ ]
7. Have you ever been told you have a heart murmur? [ ] [ ]
8. Have anyone of your family died of heart problems or sudden death
before age 50? [ ] [ ]
9. Have you ever had seizures? [ ] [ ]
10. Have you ever passed out or been dizzy in the heat? [ ] [ ]
11. Do you have trouble breathing or do you cough during or after exercises? [ ] [ ]
12. Do you have any sprained, dislocated, fractured, or broken bones or joints? [ ] [ ]
Explain all “yes” answers and list any ailments or conditions not listed_______________________________________
______________________________________________________________________________________________
List all medications:_______________________________________________________________________________
Assumption of Risk Agreement and Waiver
I, the undersigned participant, assume all responsibility for any and all risks of damage or bodily injury that may occur to the
undersigned while attending or participating in the Annual Dai-Ichi Shotokan Karate-Do Training Camp to be held in Panama
City, Panama. The undersigned hereby releases and discharges the Dai-Ichi Shotokan Karate-Do Association, and all its officers,
instructors, volunteers, members, camp directors, facility owners, their respective officers and agents, successors, and anyone else
involved in the conduct of this Training Camp from all claims, demands, rights of cause, or action resulting, from or arising out of
incident to the undersigned while participating in said Training Camp.
Signature: ___________________________________________ Date: _________________________
Participant
Signature: ___________________________________________ Date: __________________________
(Parent or Guardian if under 18 years)