July 29, 2017
DoubleTree by Hilton Center, 1021 Koger Center Blvd.
Richmond, VA 23235
804-379-3800
Competitor Equipment Requirements: Competitors are required for all events to bring all their own equipment. This included headgear, approved hand pads, mouthpiece and groin guards (male only), red and blue belts which are required of all competitors. You also need to bring your own weapons.
USA Karate reserves the right at any time to combine age divisions with three or less competitors.
Adult Amateur Athletic Waiver and Release of Liability Required Form
In consideration of participating in any way in The USA Karate Federation athletics/sports program, and related events and activities, the undersigned:
1. Competitors concerned about contact shall express their concerns prior to registering.
2. Agree that prior to participating, they will inspect the facilities and equipment to be used, and if they believe anything is unsafe, they will immediately advise their coach or supervisor or USA Karate personnel of such condition(s) and refuse to participate.
3. Acknowledge and fully understand that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions or negligence but the actions, inactions or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time.
4. Assume all the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability or death.
5. Release, waive, discharge and covenant not to sue The USA Karate Federation, its affiliated clubs, regional sports organizations, their respective administrators, directors, agents, consultants, coaches, and other employees of the organization, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessees of premises used to conduct the event, all of which are hereinafter referred to as "releasees" from any and all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releasee or otherwise,
The undersigned have read the above waiver and release, understand that they have given up substantial rights by signing it and sign it voluntarily.
Printed Name:
Contestants Signature Date / /
Youth (Under 18) Amateur Athletic Waiver and Release of Liability Required Form
In consideration participating in any way in The USA Karate Federation athletics/sports program, and related events and activities, the undersigned:
1. Parent or Guardian agrees that if they concerned about size differences or about contact are will express their concerns prior to registering for this event.. They acknowledge that additional safety equipment over and above that required in the rules is allowed at their option. Parent or Guardian also acknowledges that protests over the age or skill divisions of a competitor must be made prior to the start of the championships.
2. Agree that the parent(s) or legal guardian(s) will instruct the minor participant that prior to participating, he or she should inspect the facilities and equipment to be used, and if the participant believes anything is unsafe, he or she will immediately advise his or her coach or supervisor of such condition(s) and refuse to participate.
3. Acknowledge and fully understand that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions or negligence but the actions, inactions or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time.
4. Assume all the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability or death.
5. Release, waive, discharge and covenant not to sue The USA Karate Federation, its affiliated clubs, regional sports organizations, their respective administrators, directors, agents, consultants, coaches, and other employees of the organization, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessees of premises used to conduct the event, all of which are hereinafter referred to as "releasees" from any and all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releasee or otherwise.
The undersigned have read the above waiver and release, understand that they have given up substantial rights by signing it and sign it voluntarily.
Parent or Guardian Signature (Signature/Relationship) Date / /
Parent or Guardian Signature (Signature/Relationship) Date / /
Printed Name of Parent or Guardian:
Printed Name Of Student:______