Registration Form  
Personal Information  
Select Role*:
First Name *:
Last Name*:
Sex*:
Date of Birth*: (mm-dd-yyyy)
Age*: years

Parent/Guardian Name :
Email Address*:

Note: Due to some issues with hotmail, please use a different account to register

Repeat Email Address*:
Weight *: lbs
Height: feet inches
Rank/ Belt Holder*:

Note: ID Picture - Upload only JPG / JPEG Format, No Bigger than 7 MB

ID Picture*:
Years of Experience : years
School Information  
Name of School/Training Center*: use your school’s “OFFICIAL NAME”
State*:
Email*:
Phone Number*:
Tournament’s Event Information  
Tournament Name*:

Note:

Black - If you are NOT a black belt but would like to participate in the black belt division.
Adult - If you are NOT an adult but would like to participate in the adult division. ( Adult division is 18 to 32 years old ).
World Class (W/C) - Black Belt Age 12 - 32 years old Electronic HoGu(Chest Protector) Division. If you participate in W/C, check the box titled W/C; if you are participating in regular sparring, check the sparring box. Adult Rules will apply in all W/C Divisions.

Selects Event(s)*:

Note: Weigh-in for All World Class Competitors MUST be done by Friday

Total Registration Fees  :
$
Contact Information  
State*:
Phone Number*:
Liability Waiver  

LIABILITY WAIVER

In consideration of your acceptance of my registration, I do he reby, for my‐self, heirs, executors and administrators waive, release and forever discharge any and all rights claims for damages which I may have, or which may occur to me, against The America n TaeKwonDo United Inc. and for its state and district associations, 2017 American TaeKwonD o United Successors, and all members of the tournament, or their respective officers, agents , representatives, successors, and/or assigns, Hyatt Regency Orlando 9801 International Dr. Or lando, FL 32819 and against any competitors for any and all damages which may be sustained by m e in connection with my association with my participation in or entry in the above athl etic meet and competition, and in connection with any medical service I may be provided in connec tion with any such injury or illness. I understand that TaeKwonDo is a body contact sport an d I further understand all contents of the 2017 rules and regulations and general information which was published by the sponsors and I agree with them in their entirety. I further understand t hat I may be dismissed from the premises without compensation or refund if my conduct is not co urteous and cooperative for the successful operation of the championships.

Click to view all liabilities
Medical Questionnaire  
Do you have any allergies to medication? :
Do you take any medication regularly? :
Do you wear contact lenses? :
Do you have a history of:  
Epilepsy (seizures) :
Lung Disease :
Heart Disease :
Diabetes :
High Blood Pressure :

If competitor is under age 18, this must signed by parent or legal guardian.

PLEASE READ CAREFULLY!

I hereby certify that the above information is true and accurate to the best of my knowledge and hereby agree that I WILL NOT be permitted to participate in this tournament if this MEDICAL QUESTIONNAIRE FORM is not completed and returned prior to the tournament to ATU.

CERTIFICATION:

   

Note:

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