LIABILITY WAIVER, RELEASE AND CONSENT TO MEDICAL TREATMENT:
I HEREBY SUBMIT THIS REGISTRATION ANDLIABILTY WAIVER FORM TO PARTICIPATE IN THE KNOCKOUT MARTIAL
ARTS SPRING SPARRING FESTIVAL 2011. I CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT AND HEREBY RELEASE, DISCHARGE
AND WAIVE ANY AND ALL RESPONSIBILTY OF THE KNOCKOUT MARTIAL ARTS HEADQUARTERS, RED CHAPEL, KNOCKOUT MARTIAL ARTS & FITNESS,
TOURNAMENT ORGANIZING COMMITEE, EVENT STAFF, REFEREES, COACHES, INSTRUCTORS, MASTERS, AGENTS AND OTHER COMPETITORS FROM LIABILITY
FROM ANY INJURY INCLUDING DEATH AND FOR DAMAGE TO OR LOSS OF PROPERTY WHICH MAY BE SUFFERED BY MYSELF ARISING OUT OF, OR IN
ANY WAY RESULTING FROM OR ATTRIBUTABLE IN WHOLE OR IN PART TO MY TRAVELING TO, TRAINING FOR, BEING COACHED IN, USING ANY SPORTS
EQUIPMENT IN, OR PARTICIPATING IN THE KNOCKOUT MARTIAL ARTS SPRING SPARRING FESTIVAL 2011 BY SIGNING OR CHECKING BELOW I ALSO
GIVE PERMISSION TO USE ANY VIDEO OR PHOTOGRAPHS TAKEN OF ME DURING COMPETITION FOR THE PROMOTION OF THE KNOCKOUT MARTIAL ARTS
SPRING SPARRING FESTIVAL 2011 AND TAEKWONDO. AS A COMPETITOR OR PARENT/LEGAL GUARDIAN OF THE COMPETITOR I GIVE MY CONSENT
TO ANY XRAY EXAM, MEDICAL, CHIROPRACTIC, DENTAL OR OTHER TREATMENTS DEEMED NECESSARY FOR THE SAFETY AND WELFARE OF THE CONTESTANT.
I UNDERSTAND THAT THIS AUTHORIZATION IS GIVEN PRIOR TO ANY DIAGNOSIS, TREATMENTS, OR HOPSPITAL CARE BEING REQUIRED, BUT IS
GIVEN TO PROVIDEE THE MEDICAL/CHIROPRACTIC/DENTAL STAFF AUTHORITY TO RENDER CARE AS DEEMED ADVISABLE. IN THE CASE OF MINORS
IT IS UNDERSTOOD THAT EFFORTS SHOULD BE MADE TO CONTACT THE UNDERSIGNED PRIOR TO RENDERING TREATMENT, TREATMENT WILL NOT BE
WITHHELD IF THE UNDERSIGNED CANNOT BE REACHED.
I UNDERSTAND IN CASE OF INJURY, ONLY BASIC FIRST AID WILL BE AVAILABLE ON SITE, AND THAT I AM FULLY
RESPONSIBLE IN ANY OR ALL RESULTING MEDICAL OR OTHER EXPENSES.
