Print form and mail certified check or money order too Brad Hatcher 1403 E. Broadway Ave Maryville,TN 37804
NO Personal checks will be accepted
name__________________________________________age____________Phone(_______)__________________
Address_____________________________________________city______________st_____zip_______________
Instructors name and school_________________________________________________Belt__________________
How long training___________________weight________ E-Mail________________________@________._____
check divisions competing in Youth(__) Male(__) Female(__) GI(__) NO-GI(__)
Pre Registration All ages 1 div. 50.00, 2 div. 60.00 money order or certified check only (must be postmarked no later than Nov 11th, 2017 for Discount) Send to address at top of form and follow instructions
To Register by Credit card please call 865 973-0944 Pre registration via credit card is only taken Mon-Fri-10am-3pm EST
Deadline to register via credit card is Nov 15th 2017 Credit card registration 1 div. 53.00, 2 div. 65.00
I, the undersigned, understand and agree that Martial Arts is a contact sport and that injury or death could occur. In the case of injury or death to myself or my son/daughter, I will not hold Brad Hatcher/Hatchers Martial Arts/Hatchers Karate, any judges, employees, agents of Brad Hatcher/Hatchers Martial Arts/Hatchers Karate, competitors or the owners of the facility liable for any claim or demand. In case of injury or death I will use my own insurance and be responsible for any or all payments.
Print Name_______________________________Sign if 18 yrs or older__________________________________
If Under 18 Parent or guardian must sign here___________________________________________________
Certified check or money order only (DO NOT SEND CERTIFIED MAIL)
BRACKET FORMS BELOW MUST BE FILLED OUT IN FULL AND MAILED IN WITH YOUR PRE-REGISTRATION
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16 and 17 yr old male or Female may compete in the adult class with parents permission, Please sign up as Adult..
They CAN NOT compete in both adult or Teen. You must choose one group
Please Print clear All forms that apply must be filled out IN FULL
(Gi)
Name_______________________________________________ Age__________( )Adult ( )Youth
Sex________Weight_______________Rank__________________
School_____________________________________Instructor_________________________
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(NO GI)
Name___________________________________________Age__________( )Adult ( )youth
Sex________Weight_______________Years training_______________
School_____________________________________Instructor_________________________
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ FORMS ABOVE MUST BE FILLED OUT IN FULL DO NOT CUT