|
14th Best of the Best Brazilian Jiu-Jitsu ProAms
Presents
Rodrigo Vaghi
Friday, August 27, 2010
Blackburn Senior High School
2606 Hamilton Street, Omaha, NE 68131
6:30 P.M. to 8:00 P.M.
|
|
|
|
SCHOOL INFORMATION
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
STUDENT INFORMATION
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Rodrigo Vaghi Clinic
|
|
|
|
|
|
|
|
|
|
|
Questions? (402) 208-4078
|
|
|
|
14th Best of the Best BJJ ProAms Presents Rodrigo Vaghi Clinic
*WAIVER RELEASE AND ASSUMPTION OF RISK Please read carefully. This document
affects your legal rights. PRINT NAME AT TOP, SIGN AT BOTTOM.*
|
|
|
|
I
|
|
|
|
|
|
|
|
|
|
do hereby submit my application for participation in the 14th Best of the Best BJJ ProAms 2010 Rodrigo
Vaghi Clinic held at Blackburn Senior High School, 2606 Hamilton Street, Omaha, NE 68131 Friday, August
27, 2010. I hereby assume full responsibility and liability for all damages, injuries and losses that I may
sustain or incur while participating in or watching the tournament.
I realize that serious injury is commonplace in martial arts tournaments such as the one I am hereby
entering; and that even death is a very real possibility. I also realize that if i am injured, I might be
disfigured, disabled and/or rendered unable to work again. I realize that regardless of how the
consequences might occur – whether it be the result of an opponent’s actions, the action or inaction of a
referee, the condition of the mats used, the conduct of a non-partcipant or some other reason – By
entering into this agreement I accept the risk of entering and being present at the tournament and give up
and waive all claims I or anyone acting on my behalf or through me might have against D.L. Taylor
Enterprises LLC, the promoters, operators, sponsors, officials, participants, non-participants, or,
Blackburn Senior High School, Omaha Public Schools, and their agents, employees and representatives
for any injury regardless of its nature, effect or affect on me as a result of my participation and/or
presence at the tournament.
I authorize, and agree to hold harmless, whatever medical personnel that may be present at the
tournament to take any action necessary, should I become injured.
I further understand that news media and others might cover the event and that it may also be videotaped
or otherwise shown to audiences around the world. I hereby consent to having my likeness shown,
publicized, commented and/or reported on; and I do not expect to, and in fact waive any compensation I
might otherwise be entitled to as a result thereof.
I represent that I am in good health; that I am not presently, nor will I participate while under the influence
of any drug or medication; that no one affiliated with this tournament has encouraged me to enter or made
any representations regarding my fitness or ability to participate; that I have read and understood every
provision of this release; and that I am legally competent to and freely enter into this waiver, release and
assumption of risk agreement.
____________________________________
SIGNATURE (check box for electronic signature)
I am a Parent/Guardian and competitor is a juvenile
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
An "request for payment" will be sent to the attendee via Paypal for the
registration fee. Upon PAYMENT registration is complete. Please keep your
receipt.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
