California Open TDK

Referee Must Register Online by: October 04, 2024

Referees Application Form
    • This form should be filled out by parents or legal guardian if the applicant is below 18 years of age.
    • All information are kept confidential and are not shared nor sold.
    • Each participating referee will receive:
      • $100 cash compensation / $150 for International Referees
      • An official certificate
      • An invitation to a luncheon during the intermission
First Name Middle Name Last Name
Address
City State Zip
Email
Phone
Gender
Male Female
Date of Birth - -
(MM-DD-YYYY)
TKD School
School Phone Shirt Size
School Master Referee Rank / Dan#

 

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:

Declaration I declare that I have filled up this form truthfully and accurately. I am aware that any discrepancy may result to my disqualification.
In lieu of signature, please enter mother's maiden name:
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.