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ENCONTRO FEMININO 2008

ENCONTRO FEMININO 2008. REGISTRATION FORM. Saturday March 8, 2008 --- 9:30am-7:30pm Name: ___________________________________________ Rank: ________________________ NEED HOUSING: YES NO if yes, which days (circle) FRIDAY SATURDAY

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ENCONTRO FEMININO 2008

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  1. ENCONTRO FEMININO 2008 REGISTRATION FORM Saturday March 8, 2008 --- 9:30am-7:30pm Name: ___________________________________________ Rank: ________________________ NEED HOUSING: YES NO if yes, which days (circle) FRIDAY SATURDAY T-shirt (circle one): Women’s S M L XL XXL Encontro Fee: $ ______ X ____(# of people) = $ _______ PRICES ON NEXT PAGE Amount enclosed: $ __________ Once registered you will only receive 90% of your fees should you decide to withdraw the registration WAIVER OF INJURY I, (print name) __________________________________________________, the undersigned, hereby release New Wave Self Defense, its agents, servants, and employees, Silas Pinto and Fernando Fialho, individually and members of New Wave Self Defense, Grupo Ondas - Encontro Feminino, its agents, servants, and employees,  and any other persons, sponsors, associations and business entities in any way associated in this event, from any and all liability due to injuries that I may incur as a Result of my attendance and/or participation at any Capoeira Event. Furthermore, I hereby waive any compensation whatsoever for the use of pictures or video production of myself, utilized by those associated with this event, for any profit-making at anytime. I clearly understand that the physical aspect of these martial arts may involve bodily contact. I have read, understand and agree to abide by the rules associated with the event and assume all responsibility and any associated liability for infringement of such rules. Additionally, I am fully aware of my personal medical condition and hereby certify that I am mentally and physically fit to attend at this event. ____________________________________ Signature of student (in under 18 – Parent’s signature) PLEASE NOTE: TSHIRT FREE only with Pre-Registration BY FEBRUARY 15th Please mail completed form with MONEY ORDER (NO CASH or PERSONAL CHECKS PLEASE): Payable to:New Wave Self Defense 400 Warwick Ave – Warwick RI 02888 ------- BY: February 15, 2008 ------- Questions and Concerns: Graduada Aguia jrwardell137@yahoo.com

  2. PRICE LIST for CAPOEIRA PRICES ARE AS FOLLOWS for the Capoeira students ALL PARTICIPANTS SHOULD PRE-REGISTER DATES MUST BE POST MARKED BY THE DUE DATE

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