National Karate Convent

SRSBK National Karate Convention Registration

First name

Last name

Additional Family Member Names

Address

Phone

Dojo

Sensei

Emergecy Contact & Phone Number

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Individual Member Registration Fee - $150.00

Family Registration Fee - $250.00

Non-Member Registration Fee - $200.00

Youth (15 and under) Saturday Only Session - $45.00

By checking this box, I as the participant, or parent/guardian of a participant under twenty one years of age, for, in consideration of participating in the Sho-Rei-Shobu-Kan National Convention, hereby hold(s) harmless and indemnifies the Organization, Lincoln Martial Arts Center, the officers and employees thereof, the corporation(s), instructors and other members and/or students, either individually or jointly, from and against any and all claims and demands whatsoever, including, but not limited to those arising from any accident, illness, injury to or death of any person or persons resulting directly or indirectly from participation in training or any other activity related to this convention and occurring during said participation or any other time subsequent thereto. Further, the undersigned understand(s) there is a certain element of danger in the martial arts and sports and acknowledges that it has been explained that caution reduces the element of danger and injury. It is also understood that the Organization, school or corporation reserves the right to remove participant from this event for any action deemed undesirable. The undersigned stipulates that he/she is physically sound and has medical approval to proceed with normal, routine exercise. It is further understood that there are no refunds for this event.,

Thanks for registering to our event. See you there!