California Open TDK

Personal Coach Application Form
    • All information are kept confidential and are not shared nor sold.
First Name Middle Name Last Name
Address
City State Zip
Email
Phone
Gender
Male Female
Date of Birth - -
(MM-DD-YYYY)
TKD School


Coaches
: $50.00
- Includes admission fee ($15 value)

LIABILITY WAIVER

I hereby submit this registration and liability form to participate in the California Open International Tae Kwon Do Championship. I certify that the above information is true and correct and hereby release discharge and waive any and all responsibility of the The Anaheim Convention Center- Arena, Tournament Committee, Referees, Instructors, and other competitors from liability for any injury, including death, and for damage to or loss of property which may be suffered by myself arising out of, or in any way resulting from or attributable in whole or in part to my traveling to, training for, being coached in, using any sports equipment in, or participating in the California Open International Tae Kwon Do Championship. As a competitor or parent/legal guardian of the competitor, I give consent to any x-ray exam, medical, chiropractic, dental or other treatment(s) deemed necessary for the safety and welfare of the contestant. I understand that this authorization is given prior to any diagnosis, treatments or hospital care being required but is given to provide the medical/chiropractic/dental staff authority to render care as deemed advisable. In the case of minors, it is understood that efforts shall be made to contact the undersigned prior to rendering treatment, but treatment will not be withheld if the undersigned cannot be reached. I understand that in case of injury, only basic, first aid will be made available on site, and that I am fully responsible for any and all resulting medical or other expenses.

By clicking this box, I agree to the above waiver:

I am over 18 years of age. I have read and agreed to all the term and conditions of this form. I have applied truthfully and accurately.

K. S. Choi
26-D Peninsula Center Drive
Rolling Hills Estates, CA 90274
Tel: 310-377-1337 Fax: 310-541-0339
www.caopentkd.com