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Houston International Karate Championships  

TACKA Kickboxing Application


Please complete the following form, and press the submit button to send it to North Side Karate. Please fill out all information requested.


Back to Main Houston International Championships Page.

   

ONLINE KICKBOXING APPLICATION FORM:

This form is for potential Full-Contact Fighters only.   

Competitor Name:
Home Address: 
City: State:   Zip Code:
Phone Numbers:   Home:     Work:    
    Mobile:
E-Mail Address: 
Date of Birth:             Age:            Sex:  Male    Female   
Height:                     Weight:
TACKA Record: Wins:     Losses:   
Club/School Name: 
Instructor:
Club/School Address: (Include City/State/Zip)
Club/School Phone:

    

Your application will be reviewed by the appropriate parties to determine eligibility, and to make the appropriate pairings for the event. You will be contacted soon regarding your application. If you have any questions prior to being contacted, please send your inquiry to sensei@northsidekarate.com or you may contact the Chairman of TACKA at dmason8@yahoo.com.

    

Your submission of this form electronically signifies your acceptance and agreement to the LIABILITY WAIVER & RELEASE.

    

LIABILITY WAIVER & RELEASE:

I, the sender, do hereby voluntarily submit my application for participation in the said martial arts tournament & hereby assume full responsibility for any and all damages, injuries or losses that I may sustain or incur, if any while attending or participating. I waive all claims for / or against the promoters, operators, or sponsors of said tournament, individually or otherwise for any claims for injuries that I may sustain. I fully understand that I am entering such competition at my own risk & that any medical treatment given to me will be of first aid treatment type only. I declare that I am free of any physical defects of illness which might prohibit competition. I consent that any pictures taken of me in connection with the tournament can be used for publicity, promotion, or television show & I waive compensation in regards thereto. If under 18 years of age, this release & consent for to be signed by a parent or guardian. I further agree to abide by the rules of the tournament & the final decisions of the officials. I certify that the above information is correct & accurate to the best of my knowledge. 

   

    

North Side Karate reserves the right to refuse admission to any spectator or competitor.

 

 

     

 

 

 
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