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.
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.