Villari's Martial Arts Centers

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Tournament Registration

Step 1 of 3 - Enter Information

Please enter your registration information below. All fields are required.

Participant Information

First Name:
Last Name:

Gender:	Male Female
Age:

Address:
City:
State/Province:
Zip/Postal Code:

Phone:
Email:	No Email Address

Rank:
Villari's Location:	Other
Instructor's Name:

Event Selection

	Sparring		Base Price Includes 2 Events
	Kata (Forms)		Current Base Price: $55.00
	Weapons		Additional Event: $15.00

Pricing
Early	$45.00 for 1 or 2 events; $15.00 each additional event (Before 2/19/2012)
Standard	$55.00 for 1 or 2 events; $15.00 each additional event (2/19/2012 - 3/10/2012)
Late	$65.00 for 1 or 2 events; $15.00 each additional event (3/11/2012 - 3/18/2012)

Waiver

In consideration of your acceptance of my entry, I do hereby for myself, my heirs, executors, and administrators, waive, release and discharge against VILLARI'S MARTIAL ARTS CENTERS organization and/or SHAOLIN CORPORATION and/or its departments, officers, agents, representatives, successors, and/or assigns, and against any participant for any and all damages which may be sustained by me in connection with my association with or entry in the above athletic event, or which may arise out of my traveling to, participating in, or returning from said event.

I understand that the entry fee is non-refundable and non-transferable. I hereby grant full permission to VILLARI'S MARTIAL ARTS CENTERS to use photographs, videotapes, or any other record of this event.

I hereby give permission to the attending physician or other medical personnel to treat the registered individual in the event of an emergency.

Yes, I fully understand and accept the terms and conditions of this waiver.

Where victory is in daring to compete!

AMERICA'S MARTIAL ARTS PROFESSIONALS