This is a jukugo word, which usually means on'yomi readings from the kanji. If you know the readings of your kanji you'll know how to read this as well.
You at least want to be able to write your full name in Japanese, right?
For your information, my name is Ichiko Ko.
If you would please write your first and last name on the waiver, we will proceed with shooting an apple off of your head with a cannon.