Remember When Invitational
Tournament Fee’s Tournament Information
Pre-Registration Black Belt Meeting 10:15am
$45.00 for all events Start Time 10:30am, we will start on time
$55.00 at the door Events will run as followed
Spectators at the door only Breaking, Self Defense, Kata,
Adults $5.00 Weapons, Sparring, Con’t Sparring
Children 5-12 $2.00
Under 4 free
Championship Belts will be given out for first place
for Continuous Sparring only
Breaking is going to be a well promoted event all breaking material is
legal (except Glass) Breaking will be held outdoors for all to see (there will be tents in case of rain) what you bring to break, you must take home with you, you are responsible for all clean up
For more information please contact
Joel Dvorin
216-256-4298
REGISTRATION
Name Age Sex Belt Rank
Address City State Zip
Phone # DIVISIONS
Height Weight E-Mail Address
School Name Instructor
Waiver: in consideration for the acceptance of this registration which is voluntarily submitted by me, I intend to be legally bound hereby myself, executors and administrators and do waive and release any and all rights for physical, mental and emotional damages or death which I have against Joel S. Dvorin, The Unified Martial Arts Academy, The Unified Martial Arts Federation , Thompson’s Academy of Martial Arts
and any others connected with the tournament for any and all injuries suffered, damages, action whatsoever, to my person or property, I understand that any medical treatment given will be on a First Aid Basis only, I will also allow any pictures that are taken to be used within a reasonable matter, If under 18 years old this release and consent form must be signed by the competitor’s parents or legal guardian.
Signature
Parent’s Signature
Money Order’s or Cashier’s Checks Only, Payable to Joel Dvorin
4992 Horizon Dr., Richmond Hts., OH 44143
Closing Date for Pre-Registration is Sept 30, 2007 or when 2000 competitors register