ULTIMATE Taekwondo Competition Sponsored by Ww ™M Saturday May 21, 2011 Ross Middle School 3425 Hamilton-Cleves Road Hamilton, OH 45013 Competition Starts at 10:30 am On-site Registration at 9:00 am Mail or Drop off Pre Registration to: Watson's Martial Arts 3118 Springdale Road Cincinnati, OH 45254“Athlete Registration Form” Mail completed form along with payment to: Leif Watson, c/o Watson's Martial Arts, 3118 Springdale Road, Cincinnati, OH 45251 PRE-REGISTRATION PRICE = $50 for 2 events, $55 for 3levents If postmarked between May & and May 14" = $55 for 2 events, $60 for 3 events On-site Registration = $60 for 1, 2 or 3 events Entry Form Competitor Information | Name: Aa M/F Weight: Rank: GUP / DAN Address: Apt ft City State: Zip: | Phone: email School/Club Name: Instructor: a School/Club Address: Phone: City, State: Zip. Emergency Contact: Phone: Please check all that apply: Forms Breaking Sparring Total Number of Events, Total Cost. Release of Liability | agree to the following terms and conditions and consideration for competition inthe 2011 Ultimate Taekwondo Competition and its affliates, associates, competitors, referees, and instructors 1) Student agrees to abide by the rules and regulations associated with the 2011 Ultimate Taekwondo Competition 2) Student acknowledges that Taekwondo Karate is a high contact, inherently dangerous sport where contact to the head, chest, and other parts ofthe body is actually and encouraged by the rules. Student therefore acknowledge the existence of risk and personal injury in participating in said event offered by the Watson's Martial Arts and assumes all risk of personal injury without lability to the Ross Local School District or Watson’s Martial Arts (as defined above). By executing this contract and participating in sald event, the competitor agrees to release, discharge, and hold harmless, the Ross Local School Distriet or the Watson's Martial Aarts as defined above, its owners, agents, employees, instructors, competitors, referees, volunteers, and other students from al lablty claims, and actions whether known or unknown foreseen, or unforeseen, patent, or latent, for physical injury or loss of any sot, including damage to person or property in connection with the students participating in the 2012 Ultimate Taekwondo Competition | consent that any pictures furnished by me or any pictures taken of me in connection with the tournament can be used for Publicity, promotion, or television showing, and | waive any compensation in regard therato, My signature constitutes my agreement to this release. (If under 18, Release must be signed by Parent or Legal Guardian), | also understand there are absolutely NO refunds. or. | STUDENT Parent/Guardian (if under 18) DATE: