2015 CWI FRIENDSHIP TOURNAMENT HOSTED BY SUSSEX/PETITCODIAC TKD & SALISBURY TKD Saturday March 21, 2015 – JMA Armstrong High School, 55 Douglas Street, Salisbury One or Two Events - $50.00, Three - $60.00, Four - $70.00, Five - $80.00, Six - $90 NO CHEQUES PLEASE. CASH ONLY(HST Included) SORRY, NO REFUNDS Name: _____________________________________________ Phone: ____________________________ Address: ______________________________________________________________________________ TKD School & Address: __________________________________________________________________ Grade or Belt:_____________________ Instructor’s Name:______________________________________ I hereby submit my application for registration in the 2015 CWI Friendship Tournament. I agree to waive claims against any persons connected with the Tournament for any injuries I may sustain and likewise assume full responsibility for all my actions in connection with said Tournament. I further agree that any pictures taken of or by me in connection with the said Tournament can be used by the Tournament Director for publicity or promotion without compensation at this time or any other time. Signature: _______________________ Co-Signer(if under 18 yrs.): _________________________ Date: ______________________ PATTERN NAME: ______________________________________ AGE: ______ SEX: _______ BELT: __________ TAEKWONDO SCHOOL:__________________________________ PATTERN:____________________ SPARRING NAME: ______________________________________ AGE: ____ SEX: ____ BELT: _______________ TAEKWONDO SCHOOL: _______________________________________________________________ BOARD BREAKING NAME: ______________________________________ AGE: ____ SEX: ____ BELT: _______________ TAEKWONDO SCHOOL: _______________________________________________________________ WEAPON NAME: _____________________________________ AGE: ____ SEX: ____ BELT: ________________ TAEKWONDO SCHOOL: _______________________________________________________________ PAIR/TEAM POOMSE NAME: ____________________________________ AGE:____ SEX: ____ BELT:__________________ TAEKWONDO SCHOOL: _______________________________________________________________ POWER BREAK NAME: ____________________________________AGE:_____ SEX:____ BELT:__________________ TAEKWONDO SCHOOL:_______________________________________________________________