WMAA Spring Extravaganza, Lower Belt Promotion Test, and Black Belt Ceremony

Registration Form

General Info

Competitor First Name

Competitor Last Name

Email Address

Confirm Email Address

Address 1:

Address 2:

City

State

Zip Code

Phone

Participant Information

Belt Level

Age

Sex

Karate Instructor's Name

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

Date