Jawara Nantambu & Muriel Patton

Presents

J.A.W.S Martial Arts Open Championship II

TOURNAMENT REGISTRATION FORM

Saturday, May 19, 2007

Greek Orthodox Holy Trinity Church

409 Old Coachman Rd Clearwater, Fl

REGISTERATION STARTS AT 8:00 A.M

SPECIALITY DIVISIONS WILL START AT 9:00 SHARP

Name_______________________________________________________________________

Address_________________________________ City______________ ST__ Zip_________

Email__________________________ Age____ Birth Date_______ Sex__ Rank___ Weight______

Instructor_____________________________ School_______________________________

Payment Information

 

F.L.M.A. Members

$40 for 1event

Each additional event $10

Non-members

$45 for 1 event

Each additional event $15

 

Spectators $10.00

 

Mail Registration(s):

Muriel Patton / Jawara Nantambu    

7709 Cedarhurst Ln

Tampa, Fl 33625

 

F.L.M.A. Membership #  __________________

 
School Address______________________________ City___________ State___ Zip_____

Select All Divisions You Plan To Complete In:

 Weapons         
 Forms      

 Group Forms (Specialty Division)
Breaking (Specialty Division)
Creative/Musical (Specialty Division)
Point Sparring
Self-Defense (Specialty Division)
Special Needs Kata

GRAND CHAMPIONS WILL START IMMEDIATELLY AFTER ALL YOUTH EVENTS ARE FINISHED

WAIVER: I realize that karate is a contact sport and do hereby waive and release all rights and claims for damages which may occur to me or my child(ren) against the Tournament Host, Promoters, Directors, Representatives, Sponsors and Volunteers as a result of my/their participation in this event. I agree to assume full responsibility for my/their actions in connection with this event. Permission is also given to photograph or video my participation for future promotions without compensation. I have read and understand the basic rules and regulations of this event as provided to me and will hereby abide by them.

______________________________________                   ______________________________________

For Rules Go To:  http://flma.net

 

 

For More Info Contact Muriel Patton or Jawara Nantambu 813-766-7921 / 813-841-7920

 
Competitor’s Signature if 18 Years or Older        Signature if Parent/Guardian if under 18