February 11, 2012 TKO KickOff Championship

On-Line Registrations Form

Deadline is Wednesday, Feb 9, 2012

TKO 2012 KICKOFF .pdf

Please provide the following contact information:
First name Last name
Address
City, State Zip
Rank Age

 as of Jan 1, 2012
DateOfBirth Sex Male Female
Height Weight
Home Phone Work Phone
E-mail    
            Please provide the following contact information:
Club Name
Instructor's Name
Street address
City/State/Zip
Club Phone
Club E-mail
           Please provide the following ordering information:
QTY DESCRIPTION  
 Number of  Events Entering ( Your card will be billed $30.00 for 2 events and $10.00 for each additional )
Number of SPECTATOR PASS (Your card will be billed for $10 for each spectator)
Number of COACH'S/VIP "RINGSIDE" PASS-Spectator Pass is Included! Allows you to be in the Ring area to coach (Your card will be billed for $20 for each Coach Pass)
Number of TKO Nationals T-Shirt.  Please provide Sizes:    Use commas for more than one sizes.  (Your card will be billed for $10 for each T-shirt)
TOTAL DOLLAR AMOUNT  
 
We only accept Paypay payment!  Send to TKOKick@yahoo.com  
  PLEASE  NOTE!!!  You must complete and click the "SUBMIT FORM" (located below) first before using Paypal.  After you submit then you can proceed paying by using Paypal.  Please note competitor's NAME you are paying for.
Credit or debit card through PayPal
 
 
Please enter the CODE NUMBER OF DIVISIONS you are competing in. Number listed above
Example:  W-1,  F-4,  F-22, et...  
 
1st Event  2nd Event   3rd event   4th Event    5th event    6th Event  
 
PLEASE INCLUDE THE PAYPAL NAME OF THE PERSON PAYING OR ANY COMMENTS YOU WOULD LIKE TO LEAVE:
 
 

LIABILITY WAIVER. I do hereby voluntarily submit my application for participation in the "TKO KICKOFF" martial arts tournament and 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 I waive all claims for/or against the promoters, or operator, or sponsors of said Martial Arts Tournament, individually or otherwise for any claims for injuries that I may sustain. I fully understand that I am entering such competition at my own risk, and that any medical treatment given to me will be of a first aid treatment type only. I declare that I am free of any physical defects or illness that might prohibit competition. I consent that any picture furnished by me or any picture taken of me in connection with the tournament can be used for publicity, promotion, or television shows, and I waive compensation in regards thereto, if under 18, this release and consent must be signed by parent or guardian. I further agree to abide by the rules of the tournament and the final decision of the officials. I certify that the above information is current and accurate to the best of my knowledge. If I have signed below a GUARDIAN or PARENT of the undersigned minor, I furthermore acknowledge that the waivers, releases, and affirmations stated above apply to said minor I made such in behalf of said minor as the parent or legal guardian of said minor.  I furthermore agree that by submitting this form that I accept all of the above conditions.  I also understand that this is an non-refundable transaction.
 
NOTE: We do not send confirmation #.  Your Paypal payment is your verification.  Make sure you SUBMIT FORM 1st before sending payment through Paypal.  Please bring it with you on day of event as a proof of payment. Send to TKOKick@yahoo.com
            THANK YOU!

TKO Karate
Copyright © 1999 TKO. All rights reserved.
Revised: January 26, 2012 .