2003 OPEN TAEKWON-DO CHAMPIONSHIP

REGISTRATION FORM
Please Print and Fax to 876-962-9272

Please Type

Competitor Name____________________________________________________________________

Phone (_______)________________________(Work)_______________________________________

Address____________________________________________________________________________

Country___________________________City___________________Postal Code______________

Sex - Male ____ Female______ Age_______ Weight__________ Height______________

Instructor_____________________________________ School______________________________

Address___________________________________________________________________________

Events/Division (Which Event/Division you will be competing in):

Events: Patterns__________ Sparring__________ Tech. Break____________

Belt Rank: TaeKwon-Do Karate Others___________________

White _______ White _______ _________________

Yellow _______ Blue _______ _________________

Green _______ Yellow _______ _________________

Blue ________ Green _______ _________________

Red ________ Brown _______ _________________

Black ________ Black _______ _________________

Age Group

5-6 years ______ 11-12 years_______ Adult 17 years & over_______

7-8 years ______ 13-14years _______

9-10 years_____ 15-16 years _______

LIABILITY WAIVER

NOTE: EACH TEAM MEMBER MUST SIGN A SEPARATE RELEASE WAIVER

Read the following and sign. All Participants under 18 years of age must have a parent or guardian's signature.
The participant acknowledges that participation in the 2001 Open Taekwon-Do Championship is physical and participation can and often does result in injury. Being fully aware of the risks, the participant hereby expressly assumes all risk of injury or damages related to his or her attendance at or participation in the 2001 Taekwon-Do Championship, the following entities and persons; the Jamaica Taekwon-Do Association and its directors, coordinators, staff, officials, and other personnel associated with it’s production and operation; and its directors, officers, agents, staff & employees. The participant voluntarily waives all rights to seek compensation from any of the above parties for accidental or negligent damages in tort or contract resulting in any way from his or her participation in the event. In addition, in exchange for being granted participation in the 2001 Open Taekwon-Do Championship, the sufficiency of which as consideration is hereby acknowledged by participant, the participant grants to 2001 Open Taekwon-Do Championship, the unrestricted right to record, edit, and compile participant’s performance and likeness and to sell, distribute, or otherwise utilize the recording in any manner desired by those parties, and expressly waives all rights to seek compensation from those or any other parties for use of the participant’s likeness, voice, and/or performances at the 2001 Open Taekwon-Do Championship.

Signature of Participant ________________________________
Guardian’s Signature (participant is under 18)_________________________________
Date _____________________________

PAYMENT INFORMATION

Please circle one                                Money Order   Cashier’s Cheque
Make cheque payable to:                   Jamaica Taekwon-Do Association
                                                            37 Lady Musgrave Road
                                                            Kingston 5, Jamaica
NB:      NO PERSONAL CHEQUES ACCEPTED

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