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| Forms for Event RegistrationsRegistration Form"Art" of Taekwon-do Seminar***Please Print or Type*** Registration Form "Art" of Taekwon-do Seminar ***Please Print or Type***
Great Lakes Global TaeKwon-Do
Presents the 6th annual “Art” of Taekwon-do Seminar
NAME: ____________________________________________ RANK _______ AGE _______ ADRESS: ______________________________________________________________ CITY _____________________________________ STATE ___________ Zip ___________ E-MAIL _______________________________________ PHONE # _____________________ SCHOOL ____________________________________ INSTRUCTOR ____________________ EVERGENCY CONTACT _______________________________ PHONE ________________ ITF? YES_____ NO _____ AMOUNT ENCLOSED _____________ US-ITF? YES ______ NO _____ Dinner after seminar YES ___ # ___ NO ____ Pre-registration by February 10, 2012 FEE INFORMATION: Black Belt Seminar & Art of TKD seminar $80.00 Art of TKD seminar only $50.00 Black Belt Seminar only $50.00 Day of event registration one seminar $65.00 both $100.00
Checks payable to: Great Lakes Global Taekwon-do For participation requested, I do hereby, for my heirs, executors, and administrators, waive, release and forever discharge any and all rights and claims for damages which may hereafter accrue to me against representatives of Great Lakes Global Taekwon-do and Olivet Lutheran Church, seminar officials and participants, and their officers, agents, representative, successors, and or assignees, for any and all damages which may be sustained and suffered by me in connection with, association with or entry in the seminar, or which may arise out of my traveling to, participating in or returning from the event. My signature warrants that I have read and fully understand the waiver above pertaining to my request for participation in this event. Participants under the age of eighteen on the date of application require the signature of a parent or legal guardian below. APPLICANT _____________________________________________DATE: _______________ GUARDIAN ______________________________________________ DATE _______________
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