Tennessee State Jiu-Jitsu 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________________________@________._____
check divisions competing in  Youth(__)     Male(__)     Female(__)         GI(__)        No GI(__)     

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)




16 and 17 yr old male or Female may compete in the adult class with parents permission, Please sign up as Adult..
They CAN NOT compete in both adult or Teen. You must choose one group 
Please Print clear All forms that apply must be filled out IN FULL
(Gi)
Name_______________________________________________ Age__________( )Adult ( )Youth
Sex________Weight_______________Rank__________________
School_____________________________________Instructor_________________________



(NO-Gi)
Name___________________________________________Age__________( )Adult ( )Youth
Sex________Weight_______________BELT________________
School_____________________________________Instructor_________________________


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FORMS ABOVE MUST BE FILLED OUT IN FULL DO NOT CUT
Print and Mail form