Region 21

No T-Shirts This year

2019 Black Belt Camp Registration

First Name
Last Name
Association Number
Gender
Age
Rank
Studio
Studio if Outside of Region 21
Pants Size
Acknowledge Waiver

First Name
Last Name
Studio
Studio if Outside of Region 21
Acknowledge Waiver

First Name
Last Name
Association Number
Gender
Age
Rank
Studio
Studio if Outside of Region 21
Pants Size
Acknowledge Waiver

Instructor RegistratioN

BB Camp Registration


If you intend on Registering for Camp or would like to be a chaperone for Camp.  Please fill out the information below.

First Name
Last Name
Studio
Studio if Outside of Region 21
Acknowledge Waiver

Non-Chaperone Registration

Please enter the appropriate information below to register for the 2019 Black Belt Camp.Once you enter all of your information, Select "Add to Cart" which will bring you to the Pay Pal shopping cart. If you need to register another individual or purchase a T-Shirt (Not Applicable This Year), select "Continue Shopping".  Otherwise, select "Check Out".

T-Shirt Orders Closed First Name
Last Name
Size
Studio

WAIVER ACKNOWLEDGEMENT​


GENERAL RELEASE:  I hereby agree for myself and/or my child (or children, as the case may be) and our respective heirs, assigns and legal representatives, to indemnify, defend and hold the (i) World Tang Soo Do Association (“WTSDA”) and its officers, directors, board members, employees, volunteers, agents, independent contractors, instructors, counselors, participating studios, Middleburg Martial Arts, Regional Director(s), (ii) other participants, and (iii) Camp John Hope  (collectively, the “Staff”) harmless from any and all claims and causes of action of any nature for any and all personal injury or illness, including, but not limited to death, which may occur to me and/or my child or which may be aggravated during or by any activity during the course of the program in which I have decided to allow myself and/or my child to engage.  I further waive any and all claims or causes of action, which I and/or my child may now or hereafter have against the Staff which may at any time arise directly or indirectly related to my and/or my child’s participation in the program.  I further expressly understand and agree the foregoing indemnity, release and waiver is intended to be as broad and inclusive as permitted by the laws of the State of Georgia and that if any portion thereof is held invalid, illegal or unenforceable, it is agreed that the balance shall, notwithstanding, continue in full force and effect. 
ASSUMPTION OF RISK:  I, individually and/or on behalf of any minor child, expressly and specifically assume any and all risk of injury, illness, death, or property damage resulting from my Tang Soo Do (“TSD”) activities.  Further, I, individually and on behalf of my minor child, understand that TSD activities are strenuous and dangerous and should be engaged in only by persons in good health.  I understand that I should consult a physician before enrolling myself and/or my child in the TSD program. I understand the risks involved and accept all of the risks. 
MEDICAL RELEASE:  I, individually and/or on behalf of any minor child, further hereby release the Staff from any claim whatsoever which may arise as a result of any first aid, treatment, or services or assistance provided to me in connection with any injury that arises from activities at Camp John Hope.  A) I take full responsibility for my and my child(s) welfare and safety during TSD or TSD related activities.  B) I hereby give permission for emergency medical treatment to be administered as deemed appropriate. 
INSURANCE:  I UNDERSTAND THAT I MUST HAVE MY OWN HEALTH INSURANCE TO COVER ME AND MY CHILD.  I understand that the WTSDA does not carry insurance to cover injuries and losses that may befall me and/or my child.   Further, I understand and agree that should medical attention be required, I and/or my insurance provider shall be responsible for all costs associated with such medical attention.
PHOTOGRAPHIC RELEASE:  I consent, on behalf of myself and my minor child, to be photographed and to allow WTSDA to use of any photos of myself and/or my minor child at its sole discretion. 
RULE ACKNOWLEDGEMENT:  I understand that myself, and my minor child, are required to observe and obey all rules and regulations governing this seminar and failure to do so may result in me and/or my child’s expulsion from this seminar, without a refund.  Further, I acknowledge and understand that the WTSDA and its affiliated studios are private organizations and they make their own rules and regulations where are final and unappealable.  I further understand and agree that all fees paid hereunder are NONREFUNDABLE.

Chaperone Registration