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Tournament Online Registration

Competitor Name: 

Competitor Phone:

Competitor Email:

 

Age:

Belt Color

Rank: 

School

/ Dojo:

Instructors

Name:

Competing
In:

I 

hereby agree that in consideration of my registration to participate in the “Battle on the Ridge Invitational Karate Tournament” hereby referred to as (tournament), on February 18th, 2023, and having actual knowledge and appreciation of the nature of this tournament, its activities, skills and risks involved while participating, hereby voluntarily consent to my participation and assume all inherent risks associated with this event.

I HEREBY AGREE, while attending and participating in said “tournament” and using the facilities and equipment thereof, does so at his/her own risk and further assumes full responsibility for any injuries or damages arising from personal injuries sustained that he/she may suffer while participating or not on or about the tournament premises of Eagle Lake Assembly of God and does hereby forever release and discharge Eagle Lake Assembly of God, Main Street Dojo’s, LLC., USA Goju Karate Organization, any individual instructor or instructors employed by Main Street Dojo’s LLC. or its independent contractors, employees, students, agents, officials, representatives or volunteers and any other person or persons at Main Street Dojo’s, LLC., from any and all claims, demands, damages or causes of action, whether known or unknown, anticipated or unanticipated, resulting from the negligence or not of Eagle Lake Assembly of God, Main Street Dojo’s, LLC., USA Goju Karate Organization, or any other individual instructor, tournament judge or volunteer or any other persons using the premises whether a participant or not and whether employed or not by Main Street Dojo’s, LLC.’s.

I further agree that Main Street Dojo’s LLC. or USA Goju Karate Organization shall not be liable for any damages arising from personal injuries sustained by the participant in, on or about the premises of any USA Goju Karate Organization School, or at any public or private Karate Tournament, contest or exhibition whether traveling to or from this or any event. The participant agrees that any and all pictures, movies, radio or TV appearances of the student may be used by Main Street Dojo’s LLC. or USA Goju Karate Organization without compensation to the participant.

I acknowledge that I have fully read and understand the conditions of this registration and liability release agreement and also warrant that I am in good physical health and that to the best of my knowledge I do not suffer from high blood pressure, heart ailments, or any latent physical disabilities which, based on competent medical advice, would preclude me from participation in the Battle on the Ridge Invitational Karate Tournament. I also grant permission to Main Street Dojo’s LLC., its representatives and agents to authorize and obtain medical care from any licensed physician or hospital should I become ill or injured as a result of my participation in this event, if either a parent or guardian is unavailable to grant authorization for emergency treatment.Participant’s Name, PLEASE PRINT)

I further agree to abide by all the rules and regulations set forth by and for this event and accept that my failure to comply with these rules may result in my immediate disqualification from this event, and that no monies will be refunded to me.

As Parent / Legal guardian I acknowledge I have read this Registration and Liability Agreement and understand agree to all of its provisions thereof.

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Parent / guardian if participant is under 18                                                                              

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Date Parent Signed:

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