Tennessee State Martial Arts Championships
Print form and mail certified check or money order too Brad Hatcher 1403 E. Broadway Ave Maryville,TN 37804
NO Personal checks will be accepted



Instructors name and school_________________________________________________Belt__________________

How long training___________________weight________ E-Mail________________________@________._____

Divisions Competing  Grappling GI( ), Grappling No Gi ( ), Karate sparring ( ), Forms ( ), Weapons, ( ) Continuous ( )

I, the undersigned, understand and agree that Martial Arts is a contact sport and that injury or death could occur. In the case of injury or death to myself or my son/daughter, I will not hold Brad Hatcher/Hatchers Martial Arts/Hatchers Karate, any judges, employees, agents of Brad Hatcher/Hatchers Martial Arts/Hatchers Karate, competitors or the owners of the facility liable for any claim or demand. In case of injury or death I will use my own insurance and be responsible for any or all payments.

Print Name_______________________________Sign if 18 yrs or older__________________________________

If Under 18 Parent  or guardian must sign here___________________________________________________
Certified check or money order only (DO NOT SEND CERTIFIED MAIL)

Print and Mail form