PLEASE CHOOSE BELOW WHICH SEMINAR TIME YOU WILL ATTEND

High Performance Martial Arts
212-85 26th Avenue, Bayside, NY 11360
11:00AM ($120)
ATTENTION
Please bring full sparring gear, Daedo Socks, and water


EMAIL APPLICATIONS MUST HAVE CREDIT CARD INFO


LIABILITY WAIVER (MUST BE SIGNED)


I hereby submit my application for the Northeast Regional Olympic Sparring Seminar. I understand that this martial art seminar is a body contact sport and that my participation in this sport involves some risk of injury. I knowingly and voluntarily assume all risk of injury. I hereby release High Performance Martial Arts, and it’s Instructors, employees, coaches, organizers, and administrators for any responsibility for injury suffered during the seminar. I understand further that I shall strictly obey the rules and regulations governing this seminar in the event of such injury. I hereby give my consent to receive the appropriate medical treatment.
I further agree that any pictures taken of or by me in connection with the seminar can be used by the organizers for publicity or promotion without compensation at this time or any other time. I acknowledge that I have read carefully the above and understand it fully, and I voluntarily agree to be bound by the terms specified herein.

Clear
SIGNATURE
DATE (18 years and older)
Clear
PARENT/ LEGAL GUARDIAN SIGNATURE
DATE (18 years and older)