11:00 AM – 2:00 PM
Seminar
Fee: $100.00
Must Register by
November 1st
All MUST Pre-Register -Space
Limited
NO Registrations at the door -
NO Spectators - NO Exceptions
Name: ________________________ Age: ___________
Address: _________________________
City: ________________
State: ________ Zip: _________ Telephone: ______ - _____
- _______
*NON-REFUNDABLE Amount Paid:
$______________
NOTE: Mail Payment and registration form to:
The EDGE
Ultimate Martial Arts
101 Route 46 West, 2nd Floor
Saddle Brook,
NJ 07663
Or...E-mail
to [email protected] with credit card information to secure your spot.
Liability
Waiver
We,
the seminar participant and guarantor if applicable on behalf of ourselves,
members of our family, our heirs, executors, administrators and assigns, hereby
forever release, discharge and hold harmless, The EDGE Ultimate Martial Arts,
Richard Raciti, representatives and agents for any
injury, loss, or damage to my person or property howsoever caused, arising out
of or in connection with my taking part in martial arts classes and activities
and notwithstanding that the same may have been contributed to or occasioned by
the negligence of The EDGE Ultimate Martial Arts, Richard Raciti,
Representatives, or agents. NOTE: Participants must supply their own
protective equipment. *After registering for the seminar your space is reserved
therefore no refunds will be given for those who do not attend the seminar.
______________________
______________________________
Signature Parent/Guardian
if under 18 years.