Samurai Movie Night Registration Form 2026

Samurai Movie Night Registration Form

Join the Japanese Mutual Aid Society and the Japanese American Service Committee for a revival of community Samurai Movie Nights! Enjoy a screening of the classic film Yojimbo with popcorn, drinks, and friends!
Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number
Format: (000) 000-0000.
Number of Guests
Disclaimer: While guests of all ages are welcome, please note that Yojimbo is intended for adults (18+) and contains themes/violence that may not be appropriate for children.

Part 2: Event Details
Date & Time: Friday, June 12th, 2026 at 6:00 pm.

Location: JASC, 5700 N Lincoln Ave, Chicago, IL.
There is no offical cost of the event but there is a suggested donation of $5-$10. You are also able to donate the day of event.
Donation Amount
Donation Sum

Your Donation

USDDescription

Please complete your donation by clicking one of the payment buttons below to process your gift.

If you pay by credit card or debit card, please click the submit button below after entering your information to complete your donation.

if you choose to use a PaylPal account, your form will automatically be submitted after you enter your PayPal payment.
Should be Empty:

Samurai Movie Night Registration Form