Championship Form Veterans

Transcription

Championship Form Veterans
Name of Championship: All India Invitational Veteran's Karate-Do Championship
Name: ………………………………………………………………………………………………………………….
Age: ……………………………………..Date of Birth: ……………………………………………………………….
Weight: ………………………………..Belt: ……………………………………………………………………..
Contact: ……………………………………E-mail: ………………………………………………………………
Date: ……………………………………….Place: …………………………………………………………………
Kata
Kumite
M/F
Consent
I………………………aware that karate is a contact sport & that injuries may occur in the course of
participation. I am also aware that term injuries includes injuries of every description including
temporary disablement, permanent & also loss of life.
I………………………...authorized & consent to being rendered all medical treatment, in case of any injury
accident during the journey/travel/competition/practice/stay by the SHOTOKAN SCHOOL KARATE-DO
ASSOCIATION OF INDIA and those associated with it. I agree to reimburse the cost of such medical
treatment & any other incidental expenses so incurred.
I………………………..state that I am participating in the above tournament at my own risk & responsibility
at to the cost and consequences and that I have read and understood the aforesaid and I have signed
this consent form of my own free will.
COMPULSARY THINGS FOR PARTICIPANTS:1. Karate Dress
2. Aka, Ao Gloves, Shin guard, Body Protector, Chest guard, Gum Shield
3. First Aid
Signature & Name