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
name__________________________________________age____________Phone(_______)__________________
Address_____________________________________________city______________st_____zip_______________
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)
