New Registration Page

This is the new membership application form exclusively for those under 18 years old.
A consent form from a guardian/custodian is required for membership. Please download the " Consent Form," fill it in, and upload the completed form via the "Consent Form" section of this application.

Title *
Name *
  • Full Name

    • * Please enter your name in this order (Family First Middle).

  • Last Name(Family Name)
  • First Name(Given Name)
  • Middle name

    • * Middle name is not required.





Gender *
Date of Birth *
    / /
DAYMONTHYEAR
Email-address *

（Re-type Email-address）

Mailing Address *
Address for registration *
  • Street1
  • Street2
  • City
  • State
  • Zip
  • Country1 A-N
  • Country2 M-Z






Please fill in "Street1". Please select your Country from "Country 1" or "Country 2".
Phone number

(without Country code and hyphen) Please fill in your phonenumber either "Home phone" or "Personal mobile phone", or both
Address for registration *
  • Street1
  • Street2
  • City
  • State
  • Zip
  • Country1 A-N
  • Country2 M-Z






Please fill in "Street1". Please select your Country from "Country 1" or "Country 2".
Phone number

(without Country code and hyphen) Please fill in phonenumber either "Company phone" or "Company mobile phone", or both.
Company *

Please fill in capital letters. Please fill in Company name.
Position

Please fill in capital letters.
Smoking Room
Check-in Date
    / /
DAYMONTHYEAR
（If you have a room reservation, please inform us your check-in date.）
Agreement of the terms and conditions ※
Consent of e-mail newsletter delivery ※
Consent Form ※
Please download the " Consent Form," fill in the required information, and upload the completed form.
*Accepted file formats: ".pdf," ".jpg," ".jpeg," ".png"

When 'ファイルを選択' is displayed, please click it and select a file.