Team Captain’s Name__________________________________ Phone#: (____)-_____-________

Address: ________________________________ City:_____________ State:_____ Zip:_________

Event entered: Pairs ______ (2 people (Male/Female)) Group ______ (3 people)

Team Entry Fee: Pairs - $50.00 Group - $50.00
Make Checks Payable to: “Tae Park World Class Tournament”
Masters, please send entries in before ****November 1, 2008****
Mail entries to: Master M. Madden, 1063 32nd St. SW, Wyoming, Michigan 49509

In consideration of your acceptance of my registration, I do hereby for myself, my heirs, executors, and administrators forever waive, release and discharge any or all rights / claims for damages which I may have or which may accrue to me against Tae Park Institute, including all sub-Institutes, Master Instructors, Tae Park Tae Kwon Do, World Tae Kwon Do Federation, Grand Rapids Community College, all workers, volunteers, and members of the tournament or their respective officers, agents, representatives, successors, and / or assignees, and against any competitors for any and all damages which may be sustained by me in connection with, or association with, participation in, or entry in the above athletic meet and competition, or in connection with any medical services that may be provided for any such injury or illness. I agree to release all of the above for their own negligence. I understand that Tae Kwon Do is a body contact sport. I further understand that I may be dismissed from the premises without compensation or refund if my conduct is not courteous and cooperative for the successful operation of the tournament. I, the undersigned, do understand that the registration fee is non-refundable.

Master Instructor Signature: ________________________________________ Date:_____________