Tournament Registration

Copyright © 2010-11. All rights reserved    AIM USA INC

Students Last Name

Students First  Name

Students Age

Street Address

City

State

Zip

Parents Last Name

Parents First  Name

Home Phone Number

Work Phone Number

Cell Phone Number

Email address

Students Belt Rank

Stripes

TOURNAMENT REGISTRATION OPTIONS

OPTION #1 

To receive a discount pre register online now.  Registration online is a two step process. All pre                           registrations must be received before 2-26-2012. ~ Pre-registered students may pick up their entry forms  and  paperwork on 3-3-2012 at Powhatan High School ~

• First step................complete the online registration form below and submit. 
  

• Second step.......... make payment online.
  

OPTION #2  

To receive a discount pre register by mail download the registration form complete and mail                                with payment to: AIM USA 2434 New Dorset Circle Powhatan VA 23139. All pre registrations must                           be received before 2-26-2012. Please make checks payable to AIM. Please do not turn in your                                tournament registration / payment at class.  ~ Pre-registered students may pick up their entry forms  and  paperwork on 3-3-2012 at Monacan High School ~

OPTION #3  

Register and pay in full at the door. Please bring your completed registration form with you on 3-3-2012.

Instructor or Class  Location

Event(s) you are participating in

Number of  spectators ages 6 & up $2.00

Please  check the "I am making payment online" box then click submit to send your pre registration information.  After clicking submit you will proceed to step #2 "make payment online" 

Please note..... to finalize your online pre registration step #2 must be completed.

Tournament patch

I, the undersigned, as parents/legal guardian of the child registered on this form do hereby voluntarily submit their application for attendance and participation in the Athletes in Motion, LLC / AIM USA, INC. Tournament and hereby assume full responsibility for any and all damages, injuries, or losses that they may sustain or incur, if any, while attending or participating, and I waive all claims against the promoters, or operators, or sponsors of Athletes in Motion, LLC / AIM USA, INC. individually or otherwise for any claim or injuries that they may sustain.  I fully understand that any medical treatment given to my child will be of a first aid treatment type only.  I consent that any pictures furnished by me or my child or any pictures taken of me or my child in connection with the  tournament can be used for publicity, promotion, videos or television show, and I waive compensation in regards thereto.

I agree to the terms and conditions stated in the liability release

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White BeltYellow BeltOrange BeltPurple BeltGreen BeltBlue BeltRed BeltBrown BeltBlack Belt

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Adult DivisionWhite Belt Both EventsWhite Belt Best Punch & KickWhite Belt Danger AlleyYellow Belts Both Events Yellow Belt Sparring Yellow Bely S.W.Y.K Orange Belt Both Events Orange Belt SparringOrange Belt S.W.Y.K. Purple Belt & Above Both Events Purple Belt & Above Sparring Purple Belt & Above Forms

Yes I would like to order my tournament patch $8.00
No thank you $0.00

I am making payment online