WAIVER / REGISTRATION FORM "HALL of FAME" OPEN 2003

INTERNATIONAL CHINESE MARTIAL ARTS

TOURNAMENT OF CANTON

REGISTRATION FEES

Postmarked prior to 15 Sept, 2003:First Event$40

At the door and "late" (After 15 Sept, 2002)First Event$50

Each Additional Event $10

Number of Events Entered Total Amount Enclosed .

For Registration:(1) Complete both sides of this form (waiver and event registration).

(2) Enclose a Money Order or Cashiers Check for the appropriate amount. Credit cards accepted by phone. Call (330) 327-5699, Monday – Friday 6 to 8 PM (EST), or Saturday 9 AM to 2 PM.

(3) Return form and registration fee by 15 September, 2003 in order to avoid late fees. (No personal checks accepted. No refunds.)

Make Money Order / Cashiers Check payable to: Wu Tang Martial Arts Association

Mail to:Wu Tang Martial Arts Association

1063 S. Arlington St.

Akron, OH 44306 USA

Please complete the following:

NAME: ADDRESS: . CITY: STATE: ZIP CODE: . COUNTRY: PHONE / FAX: E-MAIL . STYLE(S): AGE: WEIGHT: (LBS) INSTRUCTOR / MASTER: PHONE / FAX: . E-MAIL SCHOOL / ADDRESS: . . . .

Please read the following waiver and sign below

I, the undersigned, knowingly, without duress, do voluntarily submit my entry into the "Hall of Fame" Open 2003 International Chinese Martial Arts Tournament of Canton tournament. I assume all risk of personal, physical and mental disabilities, injuries, death or losses, which may result from participating in this tournament. Acting for myself, my heirs, personal representatives, and assignees, I so hereby release Tony Yang, Wu Tang Martial Arts Association, its officials, agents, representatives, employees, and all other members from liability due to any injuries or death incurred and any resulting legal claims, actions, suits, or controversies. I also understand that there is a great risk of injury or death involved in all the competitive divisions, particularly fighting in the light contact, full contact, and submission grappling events and I assume full responsibility for all of my actions, activities or omissions during and in connection with the Tournament. I have read, understood, and agree to abide by the rules of this event, and accept all responsibility and associated liability for infringement of such rules. Additionally, I am fully aware of my personal medical condition and hereby certify that I am mentally and physically fit to compete. I consent to the use of photography / video tapes of my participation in this event for promotional purposes, and hereby waive my rights to any form of compensation or claim.

"Parent's or Guardian's signature required if contestant is under 18 years of age."

. . Signature of Contestant - Date Signature of Parent/Guardian - Date