Karate, Ju-Jitsu & Sombo NATIONALS Saturday, August 15th, 2015 Ohio University Chillicothe - Shoemaker Center Gym 101 University Drive • Chillicothe, Ohio 45601 OPEN TO ALL STYLES Karate • Kung-Fu • Tae Kwon Do • All styles of Ju-Jitsu • Grappling * 1st Place winners become an AKJU ALL AMERICAN with Patch & Certificate (1 Patch Per Person) * All competitors receive an AKJU TEAM AMERICA NATIONALS participation certificate We must receive the form and money order before July 25, 2015 I, the undersigned, do hereby voluntarily submit my application for attendance & participation in the above said tournament and assume full responsibility of any and all damages, injuries or losses that I may sustain or incur while attending or participating and I hereby wave for myself & executors all claims for injuries, damages or losses that I may sustain. I fully understand that if any medical treatment is given to me, such treatment will be of first aid only, and I fully hold harmless any care giver of any claim for injuries or damages which may result from such treatment whether given to me with or without my expressed consent. Finally, I agree to allow without compensation the unrestricted use of any photographs, films or video tapes of myself. Dear Competitor, Notice: These are 3 separate tournaments. Pre-register and save money! Send in early and you don’t have to wait in line as your card and AKJU Sports Towel will be waiting for you guaranteed. Also by pre-registration you pay only one price of $35.00 and that will cover all three events (kata, kumite and weapons) or ju-jitsu, (randori, grappling & duo) or sombo (Russian Martial Art) Don Madden 1101 Andersonville Road Chillicothe, Ohio 45601 Email: [email protected]Please Print Neat (Your Email Address, Charge Card Code and Expiration Date is Very Important) 1ST P LA C E WI N N ER becomes an AKJU ALL AMERICAN with Patch & Certificate (Only one patch per person) KARATE & JU-JITSU W E T R A V E L, W E FIG H T , W E W I N ! ! ® AMERICA’S #1 FIGHTING SYSTEM TEAM AMERICA ★ ★ ★ Signature of Contestant:________________________________________________ Date:___________________ Signature of Parent or Guardian if under age 18:_____________________________ Date:___________________ AKJU TEAM AMERICA NATIONALS AUGUST 15, 2015 July 25, 2015 $35.00 Pre-registration due by July 27, 2014 Registration at the door: $35 - 1 event, $40 2 & 3 events $35.00 Pre-registration due by July 27, 2014 Registration at the door: $35 - 1 event, $40 2 & 3 events IMPORTANT EMAIL: _________________________________________________________ Don Madden, 1103 Andersonville Rd., Chillicothe, OH 45601 SOMBO $35.00 ❑ ★ ★ Email: [email protected]FREE T-Shirt for competitors who Pre-Register ONLY!
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I N ! ! RAVEL, WE FIGH T,W EW Karate, Ju-Jitsu & Sombo (Russian Martial Art) Don Madden 1101 Andersonville Road Chillicothe, Ohio 45601 ... Karate, Ju-Jitsu & Sombo NATIONALS Saturday,
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Karate, Ju-Jitsu & SomboNATIONALS
Saturday, August 15th, 2015Ohio University Chillicothe - Shoemaker Center Gym
101 University Drive • Chillicothe, Ohio 45601
OPEN TO ALL STYLESKarate • Kung-Fu • Tae Kwon Do • All styles of Ju-Jitsu • Grappling
* 1st Place winners become an AKJU ALL AMERICAN with Patch & Certificate (1 Patch Per Person)
* All competitors receive an AKJU TEAM AMERICA NATIONALS participation certificate
We must receive the formand money order before
July 25, 2015
I, the undersigned, do hereby voluntarily submit my application for attendance & participation in the above said tournament andassume full responsibility of any and all damages, injuries or losses that I may sustain or incur while attending or participatingand I hereby wave for myself & executors all claims for injuries, damages or losses that I may sustain. I fully understand that ifany medical treatment is given to me, such treatment will be of first aid only, and I fully hold harmless any care giver of anyclaim for injuries or damages which may result from such treatment whether given to me with or without my expressed consent.Finally, I agree to allow without compensation the unrestricted use of any photographs, films or video tapes of myself.
Dear Competitor,Notice: These are 3 separatetournaments.Pre-register and save money! Send inearly and you don’t have to wait in lineas your card and AKJU Sports Towelwill be waiting for you guaranteed.
Also by pre-registration you pay onlyone price of $35.00 and that willcover all three events
Please Print Neat (Your Email Address, Charge Card Code and Expiration Date is Very Important)
1ST PLACE WINNERbecomes anAKJU ALL AMERICANwith Patch & Certificate(Only one patch per person)
KARATE & JU-JITSU
WE TRAVEL, WE FIGHT, WE WIN!!®
AMERICA’S #1 FIGHTING SYSTEM
TEAM AMERICA
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Signature of Contestant:________________________________________________ Date:___________________
Signature of Parent or Guardian if under age 18:_____________________________ Date:___________________
Send Money Order by July 27, 2012 to: Don Madden, 1101 Andersonville Road, Chillicothe, OH 45601
$35.00 Pre-registrationdue by July 27, 2012Registration at the Door$35 - 1 event, / $40.00 2&3 events
We must receive the formand money order before
July 27, 2012
$35.00 Pre-registrationdue by July 27, 2012Registration at the Door$35 - 1 event, / $40.00 2&3 events
I, the undersigned, do hereby voluntarily submit my application for attendance & participation in the above said tournament and assume full responsibility of any andall damages, injuries or losses that I may sustain or incur while attending or participating and I hereby wave for myself & executors all claims for injuries, damages orlosses that I may sustain. I fully understand that if any medical treatment is given to me, such treatment will be of first aid only, and I fully hold harmless any care giverof any claim for injuries or damages which may result from such treatment whether given to me with or without my expressed consent. Finally, I agree to allow withoutcompensation the unrestricted use of any photographs, films or video tapes of myself.
AKJU TEAM AMERICA NATIONALS AUGUST 18, 2012Dear Competitor,Notice: These are 3 separatetournaments.Pre-register and save money! Send inearly and you don’t have to wait in lineas your card and T-shirt will be wait-ing for you guaranteed.
Also by pre-registration you pay onlyone price of $35.00 and that willcover all three events