Registration Forms
IKF Point Kickboxing© Tournament – Ultimate Gym – Registration Form Saturday, April 18th , 2015- Charlotte, NC Semi-Contact- Continuous Fighting- Point Muay Thai Kickboxing Sparring Divisions - NO KNOCKOUTS! Location: Ultimate Gym- 401 East 35th Street- Charlotte, NC $40 Advance – At the door - $50 - Circle and Check Your Division Below – Matching done at event - Please Be On Time. Muay Thai International Low- Kickboxing Unified Rules BEGINNER INTERMEDIATE ADVANCED CHECK BEGINNER OR ADVANCED Under 2 yrs. 2-4 years 4 + years SENIOR 40 YEARS OLD & OLDER CHOOSE "1" WEIGHTCLASS ADULT MEN ADULT WOMEN JUNIOR BOYS JUNIOR GIRLS 1 _____ _____ _____ _____ 90 & BELOW N/A N/A _____ _____ 2 _____ _____ _____ _____ 90.1 – 100lbs N/A N/A _____ _____ 3 _____ _____ _____ _____ 100.1 – 110lbs _____ _____ _____ _____ 4 _____ _____ _____ _____ 110.1 – 120lbs _____ _____ _____ _____ 5 _____ _____ _____ _____ 120.1-130lbs _____ _____ _____ _____ 6 _____ _____ _____ _____ 130.1-140lbs _____ _____ _____ _____ 7 _____ _____ _____ _____ 140.1-150lbs _____ _____ _____ _____ 8 _____ _____ _____ _____ 150.1-160lbs _____ _____ _____ _____ 9 _____ _____ _____ _____ 160.1-170lbs _____ _____ _____ _____ 10 _____ _____ _____ _____ 170.1-180lbs _____ _____ _____ _____ 11 _____ _____ _____ _____ 180.1 -190lbs _____ _____ _____ _____ 12 _____ _____ _____ _____ 190.1 – 200lbs _____ _____ _____ _____ 13 _____ _____ _____ _____ 200.1 – 215lbs _____ _____ _____ _____ 14 _____ _____ _____ _____ 215.1 – 230lbs _____ _____ _____ _____ 15 _____ _____ _____ _____ 230.1 – Above lbs _____ _____ _____ _____ Mail Form and Fee to: Johnny Davis or AK Promotions P.O. Box 1804 Dillon, SC 29536. No Checks after 4/10/15: TIMES Reg. 9:AM: Rules Meeting:10:30P ALL FIGHTERS AND TRAINERS Eliminations: 11:AM (843)773-1005 – E-Mail - Questions [email protected] CONSENT AND RELEASE I, the competitor named here, by submitting this application understand that I am assuming all risks and consenting to release Johnny Davis’ The Art of Kickboxing (AK) Promotions, Dillon Kickboxing and Boxing Club, The International Kickboxing Federation (IKF), The International Point Kickboxing Organization, International Fight Sports, Steve Fossum, Ultimate Gym, Doug Bradford or any of its owners or members and all other persons associated with this event or facility in any capacity from any liability arising out of injuries, death etc., that I may incur as a result of my attendance and, or participation at this event. Furthermore, I hereby waive any compensation whatsoever for use of pictures, movies, media coverage, etc., utilized by those associated with this event for profit or promotional needs, at any time I clearly understand that the fighting aspects of this competition involve bodily contact. I have read, understand and agree to abide by the rules governing this event and assume all responsibility and any associated liability for infringement of such rules. Additionally, I am fully aware of my medical condition and hereby certify that I have my own insurance coverage and am mentally and physically fit to compete in this IKF Point Kickboxing. Moreover, I have had training in the styles of Kickboxing (Boxing and Kicking I further agree that the registration fee is not refundable unless the event is cancelled. Name: _____________________________________Address: _______________________City__________State ____Zip _____ Phone: _____________________________Instructor: ____________________________________________________________ Martial Arts School: _____________________________________________________________Phone: ____________________ School Address: ___________________________________________________________________________________________ Sign: ___________________________________________ Date: _____/_____/_____ Signature or Guardian assuming_______ responsibility for said minor – under 18. More Info. www.IKFPKB.com- (843)773-1005- [email protected] Email -
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