Registration Form

#request.event_Title#

Registration Complete

Registration Information

First Name:#Session.FirstName#
Last Name:#Session.LastName#
Email:#Session.Email#
Address1:#Session.Address1#
Address2:#Session.Address2#
City:#Session.City#
State:#Session.State#
Zip:#Session.Zip#
Phone:#Session.Phone#

Student Information

Age:#Session.Age#
Sex:#Session.Sex#
Belt:#Session.Belt#
Instructor:#Session.Instructor#

Authorization to Participate

I hereby voluntarily submit my application for attendance and participation in the Tae Kwon Do Event sponsored by World Tae Kwon Do of Brooklyn and do hereby assume full responsibility for any and all damages, injuries or losses that I may sustain or incur, if any, while attending or participating, and hereby waive all claims against the promoters, operators, sponsors or facilities management, of said Tae Kwon Do Event individually or otherwise, for any claim for injuries that I may sustain.

I fully understand that any medical treatment given me will be of first aid nature only.

To agree to the above terms and conditions, please print your name and select today's date. If this application is for a child, a parent must provide authorization.

Name:#Session.AuthName#
Date:#Session.AuthDate#

Payment Summary

Type Quantity Fee Total
Tae Kwon Do Event Fee  #varPaymentMsg# 1 #DollarFormat(Session.Price)# #DollarFormat(Session.Price)#
Total #DollarFormat(Session.Price)#
Tournament Registration Confirmation
World Martial Arts Association
#request.event_Title#
#request.event_date#

#request.event_Date# #request.event_Time#

Location: #request.event_Location#

Thank you again for registering for our event. This email is confirmation of your successful registration. If any of the information displayed below is incorrect, please contact us as soon as possible.
Registration Info
First Name:#Session.FirstName#
Last Name:#Session.LastName#
Email:#Session.Email#
Address1:#Session.Address1#
Address2:#Session.Address2#
City:#Session.City#
State:#Session.State#
Zip:#Session.Zip#
Phone:#Session.Phone#
Student Info
Age:#Session.Age#
Sex:#Session.Sex#
Belt:#Session.Belt#
Instructor:#Session.Instructor#
Payment Summary
Status:#varPaymentMsg#
Amount:#DollarFormat(Session.Price)#

Contact
Anthony Tempera
World Martial Arts Association
917-648-1318