FESTIVAL OF THE KINGS Event Division(s) Registration

1. _____Logged FESTIVAL OF THE KINGS Event Division(s) Registration No. of Events Entered: ______ Male _____ Female _____ Rank ___________ Weight __________ Circle the event number(s) you are entering as listed on the Divisions sheet. 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 Y MOUTHPIECE, GROIN CUP, FOOOTPADS, GLOVES, HEADGEAR, BREAST PADS (FEMALES) SIGNATURES: PARTICIPANT ___________________________________________ DATE ________________________ PARENT/GUARDIAN/INSTRUCTOR __________________________________ DATE ________________ REGISTRATION EARLY BIRDPRE-REG AT DOOR ENTRY FEES: 15 Jun to 01Sep to 31Aug 18Nov One event $25 $30 $35 Two events $30 $35 $40 Three events $35 $40 $45 Four events $40 $45 $50 Five events $45 $50 $55 EARLY AND PRE-REGISTRATION Make MONEY ORDER or CASHIER’s CHEQUE ONLY payable to: Ted Tabura Send with Pre-Registration Entry form to: 1915 West 154th Place Gardena, CA 90249-4305 NO SCHOOL/PERSONAL CHECKS, PLEASE NO PERSONAL OR DOJO CHECKS, PLEASE NO REFUNDS General Admission: $8.00 – Adult $6.00 – Age 6-18 Children 5 yrs and under: FREE DO NOT INCLUDE GENERAL ADMISSION IN PRE-REGISTRATION PAYMENT. SEND SEPARATE MONEY ORDER OR CASHIER’S CHEQUE MAHALO NUI LOA FOR COMING….ENJOY YOURSELF….GOOD LUCK….COME AGAIN