ANNUAL WORLD KARATE UNION

HALL OF FAME KARATE

TOURNAMENT

SUNDAY, JUNE 28, 2009

THE INN AT POCONO MANOR

RTE. 314, POCONO MANOR, PA. 18349

REGISTRATION 8:00 AM

9:30 PROMPTLY!

ADULT & CHILDRENS

WEAPON COMPETITION

$40.00 ALL EVENTS AT DOOR

SPECTATORS $ 5.00 ADULT

TROPHY & $1254)0 EACH FOR

GC FORMS, WEAPONS & GC

MENS & WOMENS FIGHTING

FOR INFO ON ANNUAL WKUHOF KARATE

TOURNAMENT

OR FOR 14TH ANNUAL WKUHOF BANQUET &

SEMINARS

2009 "MEN OF HONOR" THbute To

VISIT OUR WEBSITE FOR COMPETITION RULES, DIVISIONS & DIRECTIONS AT:

www.theworldkarateunion.com

1 ITH ANNUAL WORLD KARATE UNION HALL OF FAME TOURNAMENT

SUNDAY, JUNE 28, 2009

THE INN AT POCONO MANOR

NO CHECKS ACCEPTED

DAY OF EVENT

Last Name: School Name:

First Name:_

Street Address:

City:

Country:

Instructor Name:

Street Address:

State: _Zip: City:_ State:

Country:

Telephone:( )

Age:

Rank:

D.O.B:

Telephone: (

Height:

Martial Arts Style:

)

Weight:

Events of entry: Forms: Sparring Weapons

Competition Level: Age:

Black Belt: Executive:

Entry Fees (non-refundable):

_Beginner: Intermediate: Advanced:

Sr. (45 +) must have 3 competitors!

.$35.00 3 EVENTS (pre-registered)

J40.00 3 EVENTS (at door)

$5.00 Discount WKU Ratings members. Member ID Number:

Spectator Fees:_ $5.00 (12 years & over) $3.00 (5-11 years)

In consideration of your acceptance of my registration, I do hereby for myself and my

heirs,executors and administrators waive, relaese and discharge forever any and all rights and claims for damages

which I may connection with the tournament, have or incur and those which may be accrued to me against the

WKUHOF (World Karate Union Hall Of Fame), Frank and/or, Trevor, Kami Tasetano, the promoters and/or their

heirs, the 1 ITH ANNUAL WORLD KARATE UNION KARATE UNION KARATE TOURNAMENT,

their employees, operators, officials or any persons in the restricted areas, sponsors, advertisers, owners, and/or

leasees of premise, my personal representatives, assigns, heirs, guardians and/or next of kin for any/all damages and

any claimor demands therefore on account of injury to the person or property or resulting in the death of the

undersigned, whether caused by negligence of releasees, accident or otherwise while the undersigned is in or upon

the restricted area and/or competing in, observing, or working for, or any other purpose participating in the event. I

also certify that I have NO MEDICAL CONDITIONfS) that may or will cause injury to myself or others by my

participation in the 1 ITH ANNUAL WORLD KARATE UNION HALL OF FAME KARATE TOURNAMENT.

I waive my right to any compensation in the event my picture is used for publicity in connection with the tournament.

COMPETITOR NAME: SIGNATURE:

PARENT/GUARDIAN NAME: DATE:

WORLD KARATE UNION HALL OF FAME

437 SABOL ROAD

STROUDSBURG, PA. 18360

U.S.A.

PHONE: (570) 992-3458 E-Mail: tasekat@epix.net

FAX: (570) 992-3458