Registration – 2nd Annual Round Rock Karate Invitational RM_StatsFirst Name *Last Name *Gender * Male Female Email *Address Address Line 1 * Address Line 2 City * State or Region Alabama Alaska Arizona Arkansas Armed Forces America Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State or Region * Country Zip * Phone Number *Instructor *Studio / Club *Select an optionRound Rock Karate AcademyAustin Karate AcademyChurch's Karate AcademyFire Dragon KarateK DefenseKarate MastersLegacy Martial ArtsNorth County Martial ArtsNunan's Martial ArtsPak's Karate Family Martial Arts CenterRockhold KarateSalado Creek Martial ArtsTexas Academy of Martial Arts BudaTexas Tang Soo DoThe Texas Academy of Karate NBYT Tang Soo DoDate Of Birth *Current Rank *TinyTiger/Little Dragon10th Gup - White Belt9th Gup - Yello Belt8th Gup - Orange Belt7th Gup - Orange with Stripe / Orage- Green Belt6th Gup - Green Belt5th Gup - Green Belt 1 Stripe / Green-Brown Belt4th Gup - Green Belt 2 Stripes / Brown Belt3rd Gup - Red Belt2nd Gup - Red Belt 1 Stripe1st Gup - Red Belt 2 Stripes / Red-Blue BeltCho Dan BoCho Dan - 1st Degree Black BeltEe Dan - 2nd Degree Black BeltSam Dan - 3rd Degree Black BeltVolunteer Yes No All Dans are asked to Volunteer. All dans are asked to register to volunteer. Duties will be assigned based on age, rank, and tournament need.Participation CategoriesTiny Tigers / Little Dragons DivisionSelect an optionBoth Belt Sparring and Forms ($ 50)Belt Sparring ($ 50)Forms ($ 50)IGup/ Dan DivisionSelect an optionBoth - Trad. Forms and Sparring ($ 70)Traditional Forms Only ($ 70)Sparring Only ($ 70)Additional CategoriesAdditional Categories Weapons - 6th Gup and Above Only ($ 10) Breaking - Gup and Dan Divisions ($ 10) Tournament T-ShirtsParticipant T-Shirts Size *Select an optionYouth - Medium ($ 0)Youth - Large ($ 0)Small ($ 0)Medium ($ 0)Large ($ 0)X-Large ($ 0)This is a complimentary gift from RRKA to all ParticipantsAdditional T-Shirts Youth Medium ($ 20) × Youth Large ($ 20) × Small ($ 20) × Medium ($ 20) × Large ($ 20) × X-Large ($ 20) × Waiver *I, the undersigned, for myself or on behalf of my minor child, any heirs, executors, and administrators thereof, recognizing there is a risk of injury, do hereby waive, release and forever discharge any and all rights and claims for damages which I may have or which may accrue against Round Rock Karate Academy LLC, its affiliates, officers, representatives, successors, my own studio, my own instructor, the Kalahari Resort, the facilities being used for the tournament, and their workers and/or successors or assigns and against any competitors for any and all injuries, losses, or damages, including, but not limited to personal injuries, property damage, or death, which may be sustained by me. I will obey all required rules and regulations and also assume full responsibility and liability for any of my actions during and in connection with this Tournament. If I, or any of my guests, violate any event or facility rules, I understand we will be ejected from the event without a refund. I agree that my performance or attendance at the event, or both, may be filmed or otherwise recorded, and I consent to the use by Round Rock Karate Academy LLC, its assignees, and licensees including any public news media, of my name, likeness, voice, poses, pictures and biographical form or language with or without other materials, throughout the world without limitation, for television, radio and/or theatrical motion pictures by any devices now known or hereafter devised, and I waive any compensation whatsoever in connection with the foregoing and waive all rights to any intellectual property rights which may arise therefrom. I further understand and agree that all fees paid hereunder are NONREFUNDABLE.I AcceptSelect a payment method * Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
