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Tournament Fees

Student Information

Student Name
Student Name
Student’s First Name
Student’s Last Name
Student Date of Birth
Select the student’s approximate weight.

Responsible Party Information

Responsible Party Name
Responsible Party Name
First Name
Last Name
Liability Waiver
In consideration of your acceptance of my enrollment, I do hereby, for myself, my heirs, executors, and administrators waive, release, and forever discharge any and all rights and claims for any damages which I may have or may accrue to me against Professional Karate Institute and its organizing committees, and all members in connection with this training and/or event. I understand that Ju Ki Do is a body-contact sport which involves a risk of injury including permanent disability, paralysis, and death; therefore, I fully accept and assume all such risks and responsibility for losses, costs, and damages incurred as a result of the participation in the said training and /or event.
Media Consent
Electronic Communications Consent
Certification
$USD
Amount
Credit Card