Forms for Event Registrations

Registration 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
Sylvania, Ohio, USA
February 17 & 18, 2012
Taught by Robert N. Wheatley
VIII Dan, President of the USITF, Head of the ITF Promotions Board

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
                                          5429 Schultz Drive
                                          Sylvania, Ohio 43560 

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 _______________