REGISTRATION FORM 2013 KI MARTIAL ARTS CHALLENGE
(Submit by Email)
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| Please fill out one registration form per competitor |
First Name
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Last Name
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Address
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City
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State
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Zip
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Phone
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Email
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Martial Art School
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Instructor
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Sex
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Age
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Rank
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| Divisions in which competing: |
Forms
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Weapons
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Sparring
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Any comments or questions:
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CREDIT CARD PAYMENT OPTION |
| Name on card
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Expiration date
Card type:
VISA
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| Account number
CVV number
Zip code of card
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(The CVV number is a three-digit security code on the front of your Mastercard or VISA) |
| The above Competitor (and, if under 18, by the Competitor's parent or guardian on behalf of the Competitor) assumes full responsibility, risks and waives all claims for all damages, injuries or losses that Competitor may sustain or incur, if any, while attending or participating in the KI Tang Soo Do Tournament or events. Competitor releases all claims against the promoters, operators, or sponsors of the KI Tang Soo Do Tournament and events ("Released Parties") for any injuries or damages Competitor might sustain. Competitor fully understands that any medical treatment given will be First Aid treatment only. Competitor consents that that any picture furnished by Competitor or any picture taken of Competitor in connection with the tournament or events can be used for publicity, promotion or television showing and Competitor waives compensation in regard thereto. If Competitor is under 18, the undersigned parent or guardian agrees to indemnify the Released Parties for all losses arising from injuries the Competitor suffers while participationg in the KI Tang Soo Do Tournament or events. |
| Signature of Competitor (over age 18) or Parent
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