NZ Freestyle Martial Arts Multi-Style Karate Tournament
Registration Form

Please ensure this is filled in correctly and clearly

NAME:_____________________________________________________________________________

STYLE/SCHOOL:_____________________________INSTRUCTOR:___________________________

ADDRESS:_________________________________________________________________________

AGE: __________	GENDER:_________	WEIGHT:__________ YEARS TRAINING:_____

RANK(KYU/DAN):_________________	BELT COLOUR:__________

Entry Fees
Entrance fees are not refundable and are as follows
Pee Wee kata (7yrs & under)		$5.00		Pee Wee Kumite (7yrs &under)		$ 5.00
Junior Kata(8 -12 yrs)			$5.00		Junior Kumite (8 -12 yrs)		$10.00
Intermediate kata (13 -16 yrs)		$5.00		Intermediate Kumite (13 -16yrs )	$15.00 
Senior Kata	(17yrs and above)	$5.00		Senior Kumite (17yrs and above)		$15.00
Weapons Kata (all ranks)		$2.00

Please make cheques payable to NZ Freestyle Martial Arts

Division(s) :	please tick every event you wish to enter

Pee Wee Kata						Pee Wee Kumite				
Junior Kata						Junior Kumite				
Intermediate Kata					Intermediate Kumite				
Senior Kata						Senior Kumite				
Weapons kata						
Type of weapon......................................................

Disclaimer:
I, the undersigned, do hereby voluntarily submit my application for attendence and participation as an individual in the above event and do hereby assume full peronal responsibility for any and all injuries, damage or loss of any description whatsoever which I may suffer or substain in the course of or consequent while attending and/or participating and hold harmless the Promoters,organizers, participants, officals and sponsors of the above event.  I fully understand that any medical treatment given to me will be of a first aid type of treatment only.


SIGNATURE:_____________________________________________________________
		(To be signed by Parent/Guardian if under the age of 18 years)

PLEASE NOTE: Only entries received on this official form will be accepted