Payment for Team Kumite division

Please enter information on this form to make payment for Team Kumite division

Paid after August 12th - $60

Team kumite 8 and under Team kumite 9 – 11 years old Team kumite 12 – 14 years old
Team kumite 15 – 17 years old Team kumite 18 years and up Kumite Doubles 8 – 9 years old
Kumite Doubles 10 – 11 years old Kumite Doubles 12 – 13 years old Kumite Doubles 14 – 15 years old
Kumite Doubles 16 – 17 years old Kumite Doubles 18 years and up  
Team Member #1
Team Member #2
Team Member #3

AGREEMENT AND RELEASE OF LIABILITY

IF YOU ARE UNDER 18 YEARS OLD THIS FORM MUST BE SIGNED BY PARENT OR GUARDIAN.

I, the undersigned, do hereby submit my entry form with intent to compete at the 2016 Hawaii Open Karate Championships. I, the undersigned do hereby understand that physical contact between competitors, and rigorous exercises are involved in this karate tournament. I understand and am aware that this tournament is a potentially hazardous activity which involves risk of injury and even death, and that I am voluntarily participating in this activity with full knowledge of the dangers involved. I, the undersigned, do hereby expressly assume and accept any and all risks of all damages, injuries (including death), or losses that I may sustain or incur while participating in the tournament, organized by the Kachi Karate LLC.

I, the undersigned, do hereby waive all claims against the opponents, judges, sponsors, Manoa Valley District Gym, Robert Koncal , Barbara Maile Chinen, Kachi Karate Hawaii, Kachi Karate LLC and its instructors, employees, representatives or volunteers from any injury (including death) resulting from any cause that I may sustain, including those caused by the negligent acts or omissions of any of the above mentioned or others acting on their behalf, or in any way arising out of, or connected with, my participation in the 2016 Hawaii Open Karate Championships. I fully understand that any medical treatment given to me will be of a first-aid nature only. I do hereby further declare myself to be physically sound and suffering from no condition, impairment, disease, infirmity, or other illness that would prevent my participation.

I do hereby acknowledge that I have been informed of the need for a physician’s approval for my participation in the 2016 Hawaii Open Karate Championships. I acknowledge that I have either had a physical examination and been given my physician’s permission to participate, or that I have decided to participate in the 2016 Hawaii Open Karate Championships without the approval of my physician and do hereby assume all responsibility for my participation.

I grant to Kachi Karate LLC, its representatives and employees the right to take photographs of me while participating in the 2016 Hawaii Open Karate Championships. I authorize Kachi Karate LLC, its assigns and transferees, to copyright, use and publish the same in print and/or electronically. I agree that Kachi Karate LLC may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. I have read and understand the above.

 
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Informations

Mail entry forms and payments to:

  • Kachi Karate
    3484 Kupaa Dr.
    Honolulu, Hawaii 96816
    USA

Or register and pay online at: www.hawaiiopen.kachikarate.com/online-registration

Download entry forms:

Entry form Kata

Entry form Kumite

Entry form Kata team

Entry form Kumite team

Entry form Kumite doubles

Deadline: August 19st, 2017

 

Payments

!!!SPECIAL EARLY BIRD REGISTRATION!!!

Paid before August 12th, 2017

  • Each Individual division: $25 per event
  • Team division: $45 per team

Paid after August 12th, 2017

  • Each individual division: $35 per event
  • Team division: $60 per team

Please make checks payable to: KACHI KARATE

Deadline: August 19st, 2017

hawaii open 2017

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