Team Application Form

2018 OZAWA CUP INTERNATIONAL KARATE TOURNAMENT

TEAM REGISTRATION FORM TEAM INFORMATION Please fill out all information and PRINT CLEARLY Team Name: We hereby submit our application for participation in the 2018 Ozawa Cup International Karate Tournament. We hereby acknowledge there are possible risks of bodily injuries Name: Team member #1 involved in competing in the Tournament. We hereby waive and release any and all claims, causes of action, loses, damages, cost expenses including but not limited to injuries, Name: Team member #2 attorney fees, either known or unknown, now existing or arise in the future that may have of whatever kind or nature against Name: Team member #3 any Tournament organizer, director, or anyone else involved in any way with the Tournament. We hereby acknowledge that the Tournament organizers for publicity, sales, or Sensei’s e-mail: promotions can use any individual, team, or any other pictures or videos taken of us in this Tournament without compensation to any individual Team member or the Team as Dojo’s name: a whole.

Dojo’s address:

City & State: ______Signature of Team member 1 (Parent if under 18) Date Country:

Zip code or Postal code:

______Signature of Team member 2 (Parent if under 18) Date TEAM DIVISION INFORMATION Team Kata Team Kumite Write Division # below Write Division # below

______TK: TS: Signature of Team member 3(Parent if under 18) Date

TEAM COMPETITION FEES EVENT Pre-registration Fee At the door Fee Division TK1: $150 cash prize $75 $105 17 & under Advance Team Kata (brown/black) Division TK2: $150 cash prize $75 $105 18-45 Black Belt Team Kata Division TS1: $400 cash prize $90 $120 Men's Black Belt Team Kumite Please send your payment and Team Registration Form to: Ozawa Cup, LLC ● PO Box 27134 ● Las Vegas, NV 89126-1134 Mail-in Registration Deadline: March 16, 2018