2017 Sparring Camp and Poomse Camp Agreement


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Camp Selection:    

BUYER/PARENT/LEGAL GUARDIAN’S INFORMATION:

First Name: Last Name: DOB:
Address: City/Town: State:
Primary Phone: Secondary Phone:
Email Address:
Martial Arts School:  City/Town, State:  
Grandmaster’s/Master’s/Instructor’s/Coach’s Full Name:

FIRST MEMBER’S INFORMATION:

 First Name: Last Name: DOB: Gender:  
Height: Weight: Group: Current Rank:  

SECOND MEMBER’S INFORMATION – If Applicable:

 First Name: Last Name: DOB: Gender:  
Height: Weight: Group:  Current Rank:

WEEK SELECTION:

Check Next to Selected Weeks

PRICING & CREDIT CARD INFO:

Weekly Price Per Member:  
Name on Card:  
Billing Address:  
Credit Card Type: Number: Exp.  
3-Digit Verification Code: Billing Zip Code:
The credit card above will be charged each week of attendance.

TERMS & LIABILITY WAIVER:

In consideration of your acceptance of my entry, I do hereby, for myself, my heirs, executors, and administrators waive, release, and forever discharge any and all rights and claims for damages, which I may have or may accrue to me against Dragon Yong-in Martial Arts and/or all persons associated with the event in any capacity, and all members of the training camp or their respective officers, agents, representatives, successors, and/or assigns, and against any of my competitors for any and all damages which may be sustained by me in connection with my association or entry in the above athletic meet and competition, and in connection with nay medical services provided to me in connection with any injury or illness, or which may arise out of traveling to, participating in, and returning from this athletic meet.  I understand that Taekwondo is a body contact sport, and I further understand all contents of the rules and regulations and general information which was published by the sponsors and I agree with them in their entirety.  I further understand that I may be dismissed from the premises without compensation or refund if my conduct is not courteous and cooperative for the successful operation of the training camp.  I waive any compensation whatsoever for the use of pictures, movies, etc. of my by the promoter.  There are no refunds.  I hereby agree to all terms and conditions of the liability waiver above.

 

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Dragon Yong-in Martial Arts https://dragonyong-in.com
Signature Certificate
Document name: 2017 Sparring Camp and Poomse Camp Agreement
Unique Document ID: 10b646447860b101bc88945c3f1f38da794a2c29
Timestamp Audit
2016-06-17 17:08:04 EST2017 Sparring Camp and Poomse Camp Agreement Uploaded by DYMA Sales - sales.dyma@gmail.com IP 71.207.145.17