REGISTRATION FORM
Hurk Choo Kwan Hapkido Seminar
Pacific Coast Taekwondo Martial Arts Schools
5786 203 Street Langley, BC Canada
| Full Name- | |||||
| School, Location & Instructor- | |||||
| Previous Hapkido Experience? | |||||
| Mail Address- Zip- | |||||
| Birth Date- M D 19 Sex- M F Today's Date- | |||||
| Telephones Home-
Office- Fax- Cell/Pager- |
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| E-Mail- URL- | |||||
| Medical concerns-(Med. alert, allergies,
previous injuries etc.) |
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| How did you hear of this event? | |||||
| Please Read Carefully I, the undersigned, hereby submit my application in this event. I voluntarily assume all risks in any way connected with my participation in this same event, and hereby wave all claims howsoever caused, including negligence against any and all persons, and any and all organizations and directors connected with this event, for any injuries that I may sustain during my participation in this competition. I also assume full responsibility for my actions and conduct during and in connection with this event. I consent to be photographed, filmed or telecast at this event, waiving all claims to compensation, for use by anyone without limitation. I will respect and abide by the rules of this facility. I am fully informed of the nature of this event and the governing rules, risks and conditions. Having read this brochure, I understand and accept: This agreement. That absolutely no refunds will be made. That poor or disruptive behavior including swearing, lack of co-operation and consideration to the Instructors, participants, or facility may result in my ejection. Prosecution by law for extreme acts is our right and will be exercised if required. |
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| Applicant's signature- | |||||
| Applicant's legal guardian/co-signer | Relationship- | ||||
| Signature- | |||||
| Accepted & approved by- Paid ?- | |||||
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