2023 SMART/MVPSF LUZON AGE GROUP TAEKWONDO CHAMPIONSHIPS Vista Mall Bataan, Balanga City, Bataan November 4, 2023 NOTE : KINDLY FILL-UP ALL THE INFORMATION NEEDED IN CAPITAL LETTERS. FIRST NAME: M.I. LAST NAME: NAME : CHAPTER: INSTRUCTOR: GENDER: AGE: BELT: TO BE FILLED BY WEIGH-IN OFFICIAL TEL. NO. HEIGHT (cm): WEIGHT (kl): CELL NO. DIVISION: CATEGORY: INSTRUCTIONS 1. Contestants agree to be bound by the competition rules and regulations. Penalties shall be imposed for violations of the rules. CERTIFICATION AND WAIVER 1. I hereby certify that the above information is true and correct. 2. I do hereby waive and release any and all rights and claims for damages against the competition official, their respective agents, or any facility of this competition, from any and all injuries which may be sustained during this competition. _____________________________________ PARENT / GUARDIAN’S NAME & SIGNATURE CONTESTANT’S SIGNATURE 2023 SMART/MVPSF LUZON AGE GROUP TAEKWONDO CHAMPIONSHIPS Vista Mall Bataan, Balanga City, Bataan November 4, 2023 NOTE : KINDLY FILL-UP ALL THE INFORMATION NEEDED IN CAPITAL LETTERS. FIRST NAME: M.I. LAST NAME: NAME : CHAPTER: INSTRUCTOR: GENDER: AGE: TEL. NO. BELT: TO BE FILLED BY WEIGH-IN OFFICIAL HEIGHT (cm): WEIGHT (kl): CELL NO. DIVISION: CATEGORY: INSTRUCTIONS 2. Contestants agree to be bound by the competition rules and regulations. Penalties shall be imposed for violations of the rules. CERTIFICATION AND WAIVER 3. I hereby certify that the above information is true and correct. 4. I do hereby waive and release any and all rights and claims for damages against the competition official, their respective agents, or any facility of this competition, from any and all injuries which may be sustained during this competition. CONTESTANT’S SIGNATURE _____________________________________ PARENT / GUARDIAN’S NAME & SIGNATURE
