Noncompetitors | Martial Arts

Registration Form

Personal Information

Select Role*:

CompetitorNon-Competitor (Coach)

First Name *:

Last Name*:

Sex*:

Date of Birth*:

Age*:

years

Note: The Competitors's age is based off the age they turn this year. It is determined by the year not the month/day.

Parent/Guardian Name :

Email Address*:

Note: Due to some issues with hotmail, please use a different account to register

Repeat Email Address*:

Weight *:

Height:

feet inches

Rank/ Belt Holder*:

Note: ID Picture - Upload only JPG / JPEG Format, No Bigger than 7 MB

ID Picture*:

Years of Experience :

years

School Information

Name of School/Training Center*:

State*:

Email*:

Phone Number*:

Tournament’s Event Information

Tournament Name*:

Note:

World Class and Sports Poomse competitors will not allowed participate in Sparring/Form division World Class Events

Selects Event(s)*:

Total Registration Fees :

Contact Information

State*:

Cell Phone Number*:

Carrier :*

Note: If you would like to receive a text message of your calling schedule to the holding area, please fill in your cell phone number and select carrier

Liability Waiver

I am the competitor, I am older than 18, I read it all and I agree*:

I am a legal guardian of the competitors, I read it all and I agree*:

Click to view all liabilities

Medical Questionnaire
Do you have any allergies to medication? :	YesNo
Do you take any medication regularly? :	YesNo
Do you wear contact lenses? :	YesNo
Do you have a history of:
Epilepsy (seizures) :	YesNo
Lung Disease :	YesNo
Heart Disease :	YesNo
Diabetes :	YesNo
High Blood Pressure :	YesNo
I hereby state that I am under the care of a physician for the treatment of and that I have been medically cleared by this physician to participate in this tournament.
COMPETITOR’S SIGNATURE DATE If competitor is under age 18, this must signed by parent or legal guardian. SIGNATURE DATE PLEASE READ CAREFULLY! I hereby certify that the above information is true and accurate to the best of my knowledge and hereby agree that I WILL NOT be permitted to participate in this tournament if this MEDICAL QUESTIONNAIRE FORM is not completed and returned prior to the tournament to . SIGNATURE DATE The competitor is minor (under 18 years old) and will be at the tournament without a parent If you are minor (under 18 years old) and will be at the tournament without a parent, the statement below must be read and signed by a parent or legal guardian and returned prior to participating in any competition or event. The undersigned competitor, (parent or legal guardian of the competing minor) represents that he has the authority to consent to the medical care and treatment of such a competitor (or competing minor) by the designees of . Name of parent or guardian DATE Signature of parent or guardian DATE CERTIFICATION: Contestant or Legal Guardian's Signature Age Parent’s Name Home Address Home Phone Number Name of Master (Instructor)

Note:

Before you click "Proceed" :
If you do not receive an e-mail within 24 hours from us, please check your junk/spam mail first before contacting us.

All Fees are non-refundable and non-transferable.

PLEASE READ CAREFULLY!

CERTIFICATION: