Grappling Tournaments : Event Registration

Registration

8th BEST of the WEST Submission Grappling Championship Registration Form

BJJ on Friday, September 28th and Submission Grappling on Saturday, September 29th, 2012

Location
Las Vegas Convention Center, Las Vegas, Nevada.

Pre-Registration ends Wednesday, September 26th, 2012. Domestic mailed registration must be postmarked by Saturday, September 22nd, 2012.

2 Registration options:
1: Proceed with online registration and pay by Credit Card or Pay Pal Now

2: Complete Registration Form and Mail with check or money order to:
GT Association
5402 Commercial Lane
Huntington Beach, CA 92649

Contestant Contact Info

First Name:
Last Name:
Email Address:
Address:
City:
State:
Zip/Postal Code:
Country:
Phone Number:
Cell Phone Number:

Payment Information

Payment Method:	Credit Card Now
Name on Credit Card (If paying by Card):

Emergency Contact Name

Emergency Contact Name:
Emergency Phone Number:

Tournament Division Options

Gender:
Age:	Weight:	lbs.
Judo Belt:
Wrestling:
BJJ Belt:
Grappling Level:
Pankration Level:

Academy Information

Academy Name:
Academy Phone Number:
Instructor Name:

Division Sign up

Event Selection:
Division:

Disclaimer and Signatures

By checking this check box, I understand the rules of the tournament and will abide by them. I understand that I am participating in a sport that usually has body contact. I assume full responsibility for all of my actions during and connected to the above tournament. I understand that martial arts are a potentially dangerous and/or fatal sport and agree that I will not hold G.T.A. or any of its employees and associates, tournament sponsors or hosting venue for any type of injury, loss, or death sustained while competing in this competition. I also state that I am in good physical condition and know of no reason why I cannot participate in this Martial Arts event. I have current and valid health insurance. I understand that divisions or weight classes are subject to change. I understand that G.T.A. does not offer refunds. In case of an emergency, I hereby authorize any licensed medical personnel to perform any accepted medical procedure deemed necessary and I agree to bear the expense of any such treatment. I also agree that my attendance and/or performance at the tournament may be photographed, filmed, or taped and used by G.T.A. and I waive any compensation thereof. I have read the rules and the release above and agree to all of its terms and enter this application to complete this form.

I Agree
Signature (REQUIRED FIELD Enter your name or if you are under 18 Parent or Guardian must enter theirs.):		Date: