Competitor Info
Name
Male/Female
Birth Date (Month/Day/Year)
Age
Name of Parent/Guardian if under 18
Street Address
City
State
Country
Zip Code
Home Phone
Cell Phone
E-mail
Years of training
Rank/Style
Weight (in lbs)
Organization/Federation Association
Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Home Phone
Emergency Contact Cell Phone
Emergency Contact Work Phone
Emergency Contact E-mail
Studio
Info
Studio Name
Head Instructor
Studio Street Address
Studio City
Studio State
Studio Zip Code
Studio Phone
Studio
Website
Divisions Entered
Division Numbers Only
Creative Multi-Directional Wood Breaking
Creative Open Breaking
Extreme Creative Breaking (pre-approval
required)
Power Concrete Hand
Power Concrete Elbow
Power Concrete Foot
Speed Board Breaking
High Jump Board Breaking
Power Board Hand
Power Board Elbow
Power Board Foot
Total number of divisions entered
I
hereby submit my registration form to the 2009 Arnold Martial Arts Festival. I
agree to save & hold harmless USBA/WBA (USBA llc), Management, Sponsor, Team
Tokey Hill, LLC., Classic Productions, Greater Columbus Convention Center, their
officers, agents, members & employees from any & all liability resulting from
injuries to any person or for damages to or loss of property owned or controlled
by me. I fully understand and shall adhere to all rules and regulations. I
release all photo & video rights that may be used for publicity, promotion
and/or media release without any form of compensation.
Signature (Parent or Guardian if under 18):
Your signature confirms that you
have read
and approve of the above release
Your entry at right will act as your
signature
