FESTIVAL OF THE KINGSEvent Division(s) Registration
_____Logged
Circle the event number(s) you are entering as listed on the Divisions sheet.
No. of Events Entered: ______
Male _____
Female _____
Rank ___________
Weight __________
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
NAME____________________________________________________ AGE _____ DATE OF BIRTH _____________
ADDRESS____________________________________________________TELEPHONE ( )___________________
CITY________________________________ STATE __________ ZIP CODE __________
E-MAIL ADDRESS _______________________________________________________________________________
DOJO NAME____________________________________________________TELEPHONE ( )________________
ADDRESS ______________________________________________________FAX NUMBER ( )_______________
CITY________________________________STATE___________ZIP CODE __________
E-MAIL ADDRESS _______________________________________________________________________________
INSTRUCTOR _____________________________________STYLE _______________________________________
I, THE UNDERSIGNED, DO HEREBY ASSUME ALL RISKS OF PERSONAL INJURY while attending, traveling to and/or from, participating in said tournament, and acting for myself, my heirs, personal representatives, and assigns, do hereby release the property owner, manager, landlord, host, sponsors, tournament officials, and the officers agents, and representatives of said organizations taking part, individually and collectively, from all liability, including claims against and suits at law or in equity for any injury, fatal or otherwise, which may result directly or otherwise from my traveling to, participating in, or returning from said contest. I further fully understand that if I am under 21 years of age, this application must be signed by my parent, legal guardian, or instructor (21 years old or over).
SPECIAL NOTE: ALL CONTESTANTS MUST BE CERTIFIED AS QUALIFIED FIGHTERS BY THEIR INSTRUCTORS. SCHOOL INSTRUCTORS MUST ASSUME FULL RESPONSIBILITY OF HIS/HER FIGHTER’S ABILITY.
S A F E T Y E Q U I P M E N T M A N D A T O R YMOUTHPIECE, GROIN CUP, FOOOTPADS, GLOVES, HEADGEAR, BREAST PADS (FEMALES)
SIGNATURES:
PARTICIPANT ___________________________________________ DATE ________________________
PARENT/GUARDIAN/INSTRUCTOR __________________________________ DATE ________________
REGISTRATION EARLY BIRD PRE-REG AT DOORENTRY FEES: 15 Jun to 01Sep to
31Aug 18NovOne event $25 $30 $35Two events $30 $35 $40Three events $35 $40 $45Four events $40 $45 $50Five events $45 $50 $55
NO PERSONAL OR DOJO CHECKS, PLEASENO REFUNDS
EARLY AND PRE-REGISTRATIONMake MONEY ORDER or CASHIER’s CHEQUEONLY payable to: Ted Tabura
Send with Pre-Registration Entry form to:1915 West 154th PlaceGardena, CA 90249-4305
NO SCHOOL/PERSONAL CHECKS, PLEASE
General Admission: $8.00 – Adult$6.00 – Age 6-18
Children 5 yrs and under: FREEDO NOT INCLUDE GENERAL ADMISSION INPRE-REGISTRATION PAYMENT. SEND SEPARATEMONEY ORDER OR CASHIER’S CHEQUE
MAHALO NUI LOA FOR COMING….ENJOY YOURSELF….GOOD LUCK….COME AGAIN
