ABU DHABI NORTHEAST CHAMPIONSHIPS 2009


INDIVIDUAL REGISTRATION FORM

SCHOOL\TEAM  INFORMATION
 Team Name :
Instructor's Name :
COMPETITOR INFORMATION
 First Name : ($75 For Adult Registration and $50 for Children and Teens)
Registration is good till midnight on August 14th and then it is $100 for adults and $75 for kids.
Last Name :
 Address : NOTE: You must use the address associated with the credit card you will be using. The entire address must match that on your credit card
 City :
 U.S. State/Canadian Province : (Do not make a selection if you do not live in the US or Canada)
 ZIP Code/Postal Code :
 Country :
 Phone :
   E-Mail :
(Complete the appropriate information for your competition category below)
NOTE: THIS IS FOR ALL GRAPPILING DISCIPLNES. JUDO, JIU-JITSU, WRESTLING, ETC…








 

 














 

 






 
(The Absolute divisions for both Men and Women are for Advanced Levels only.)

(It will be determined the day of the event if and how divisions may be combined)



















EXTRA PURCHASE
T-Shirt ($15/T-Shirt) :
Spectator ($15/Spectator) :
Dean Lister Seminar ($75/Seminar) :
FINAL AMOUNT
T-Shirts :  0  $
Items Quantity Amount
Adults - Events :  0  $
Children - Events :  0  $
Spectator :  0  $
Final Amount :  $
Dean Lister Seminar :  0  $

EMERGENCY CONTACT
 Name :
 Contact No :

 I, do hereby submit my application for participation in the ABU DHABI NORTHEAST CHAMPIONSHIPS 2009,West Orange, New Jersey, on Saturday, August 15th, 2009. I hereby assume full responsibility and liability for all damages, injuries and losses that I may sustain or incur while participating in or watching the tournament.

I realize that serious injury is commonplace in martial arts tournaments such as the one I am hereby entering and that death is a possibility. I also realize that if I am injured, I might be disfigured, disabled and/or rendered unable to work again. By entering into this competition I agree to and fully accept and assume liability for any and all injuries that I may incur expressly give up and waive any and all claims that I or anyone acting on my behalf or through me might have against ADCC North America L.L.C, the promoters, operators, sponsors, officials, participants, non-participants, or The Richard Codey Arena at South Mountain and their agents, employees and representatives for any injury regardless of its nature, effect or affect on me as a result of my participation and/or presence at the tournament.

I authorize, and agree to hold harmless, whatever medical personnel that may be present at the tournament to take any action necessary, should I become injured.

I further understand that tickets will be sold to spectators to watch the tournament; that news media and others might cover the tournament and that it may also be videotaped or otherwise shown to audiences around the world. I hereby expressly and irrevocably forever consent to having my likeness shown, publicized, commented and/or reported on; and I do not expect to, and in fact waive any compensation I might otherwise be entitled to as a result thereof.

I represent that I am in good health; that I am not presently, nor will I participate while under the influence of any drug or medication; that no one affiliated with this tournament has encouraged me to enter or made any representations regarding my fitness or ability to participate; that I have read and understood every provision of this release; and that I am legally competent to and freely enter into this waiver, release and assumption of risk agreement.

If an athlete’s registration application is accepted and the athlete permitted to compete, Organizer hereby expressly reserves the right, in its sole and absolute discretion, with or without cause, to change, modify or otherwise edit information contained upon a the registration form, including but not limited to: the athlete’s academy's name and affiliation and/or the competitor's name and/or nickname. Organizer likewise expressly reserves the right, in its sole and absolute discretion, with or without cause, to add or remove an athlete from the open weight division.

Changes to an athlete’s registration including but not limited to academy affiliation will be permitted up to one business day before the registration deadline. There will be no changes permitted to an athlete’s after that time. If an athlete or coach of an athlete wishes to make a change, any such change(s) are strictly limited to: competitor's name/nickname, academy affiliation and those member's of the academy that will be competing in the open weight division.

The head coach of an academy's competition team shall be granted the right to change a competitor's registration information. Such changes are limited to: weight division, competitor's name/nickname, academy affiliation and those member's of the academy that will be competing in the open weight division.

ADCC North America L.L.C. (hereinafter 'Organizer') hereby expressly reserves the right, in its sole and absolute discretion, with or without cause to deny a potential athlete/competitor’s registration/application for permission to compete in the event. The terms athlete and/or competitor may be used interchangeably.

If any dispute arises out of, or is any way related to your participation in this event, by entering your registration application, you are hereby expressly waiving and giving up your right to the filing of a lawsuit in state of federal court and a trial by jury. The word “dispute” as used above refers to anything, including claims for injury (which you have already waived) that may have occurred or you claim did not occur at the event. Any and all dispute(s) or any other disagreement of any nature, type or description between athlete and the event organizer or its successors and assigns regardless of the facts or legal theories that may be involved, must be resolved by binding arbitration in accordance with the Commercial Rules of the American Arbitration Association in effect at the time the proceeding is initiated. Any hearings must be held in ESSEX County. Although each party to the arbitration shall bear its own costs in connection with the arbitration, the prevailing party shall be entitled to recover its reasonable attorney’s fees. Even if a disagreement arises as to whether the any dispute is subject to binding arbitration, said dispute or disagreement shall likewise be resolved by binding arbitration

In case of minors under 18 years old.

Furthermore, if the competitor is a minor I, , hereby certify that I am parent and/or legal guardian of the above named minor who has been given my express permission to compete in the event for which we are registering. And, that I have read and understood every provision of the release of liability and that I am legally competent to and freely enter into this release of liability and assume all risk on behalf of the minor (competitor) named herein and any and all successors, assigns or any other representative acting upon the minor’s behalf.

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