Bob White's Karate Studio website -- www.bwkenpo.com
Registration Form

FREE T-shirt if signed up by March 1st, 2010

.

Fill in as complete as possible
First Name:
Last Name:
Address:
City: Zip:
Phone:
E-Mail :

Studio Name:
Instructor:
Rank:
Age:
Gender:
T-Shirt Size:
Choose one from each selection for your Divisions
($25.00 for all Three!) $35 at the Door
Forms: We will assign all participants in their respective Divisions
Individual Sparring:
Team Sparring:

Your Comments are Welcome

Name as appears on your Credit Card

By clicking the submit button you will be agreeing to the Waiver of Injury and the Photo and Video Release. Then you will be directed to the payment page where you may choose to use Pay Pal, Visa or Mastercard. Thank you for the Registration and Good Luck at the Tournament!

Waiver of Injury: I, the undersigned, do hereby voluntarily submit my or my child’s application and participation in the Annual Bob White Invitational Youth Karate Tournament. I do hereby assume full responsibility for all/any damages, injuries or losses that I may sustain or incur, if any, while attending or participating and hereby waive all claims against the promoters or sponsors of The Annual Bob White Invitational Youth Karate Tournament and Bob White individually, Calvary Chapel High School or in otherwise, for any claim for injuries my child may sustain.

Photo and Video release: In connection with my participation in the Annual Bob White Invitational Youth Karate Tournament, I consent to the use of my photograph and video or other likeness in the promotional and other materials of the Annual Bob White Invitational Youth Karate Tournament without payment or other consideration made to me.

Payment for the registration fee of $25.00 will be the next step, Submit the button below to continue.

Please click submit button only once.

10-30-2009

The form below is for online only.
(Easiest Way)
ONLINE REGISTRATION
Want to mail it or Fax it?