Studios Unis - Registration Quebec Open

QUEBEC OPEN

SEMINARS

Event :

Last Name :

First Name :

Phone :			Fax :

Address :

City :

State :
Country :			Zip :
Email :

School :

Instructor :

Belt :

Age :			Sex :

Height :			Weight :
PLEASE WRITE THE CATEGORY'S NUMBER
FRIDAY			SATURDAY
Underbelt			Underbelt
	Divisions	Ring		Divisions	Ring
Weapons musical			Weapons
Forms musical			Forms traditionnal
			Forms open
			Fighting
Junior black belt			Junior black belt
	Divisions	Ring		Divisions	Ring
Weapons creative			Weapons traditionnal
Weapons extreme			Forms traditionnal
Forms extreme			Forms creative
Forms musical			Fighting
Adult black belt			Adult black belt (Weapons)
	Divisions	Ring		Divisions	Ring
Weapons extreme			Hard style traditionnal
Weapons musical			Hard style creative
			Soft style
			Traditionnal creative
Continuous fighting			Adult black belt (Kata)
	Divisions	Ring		Divisions	Ring
Continuous fighting			Korean
			Japan Okina.
Team fighting			Hard style creative
Divisions		Ring	Soft style
			Traditionnal
			Creative
			Traditionnal creative
Divisions		Ring

Team synchro			Adult black belt (Fighting)
Divisions		Ring		Divisions	Ring
			Fighting
Team demo
Divisions		Ring











Regarding my registration to this athletic event, I hereby declare that me, my administrators, or the executors of my will, will not intend any civil or kind of legal pursuit against "LES STUDIOS UNIS D'AUTO-DÉFENSE INC." or any of it's subsidary, administrators or agents, in the event of an accident that could happen to me during the transport back and forth to the event or during the competition itself.
Signature :			Date :
Parent, Guardian (if under 18 year old) :			Date :
------------------------------------------------------------------------- Must be signed at the registration office on the competition's day ! -------------------------------------------------------------------------

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