Special requests, or if the competitor's last name is different from the person
that is paying by Paypal:
By submitting this form, I do hereby voluntarily enter my application for
participation in the AOK State Championships and hereby assume full
responsibility for any and all damages, injuries or losses that I may sustain or
incur, if any, while attending or participating.
I waive all claims for/or against the promoters, or operators, or
sponsors of the AOK State Championships, individually or otherwise for any
claims for injuries that I may sustain. I
fully understand that I am entering such competition at my own risk and that any
medical treatment given to me will be of a first aid treatment type only.
I declare that I am free of any physical defects of illness, which might
prohibit competition. I consent
that any picture furnished by me or any picture taken of me in connection with
the AOK State Championships can be used for publicity, promotion or television
show, and I waive compensation in regards thereto.
If under 18, this release and consent is to be signed by parent or
guardian. I further agree to abide
by the rules of the tournament and the final decisions of the officials.
I certify that the above information is correct and accurate to the best
of my knowledge. The Executive Board and Producer (s) of the AOK State
Championships reserve the right to refuse entry to anyone.
If the competitor is under 18 yrs. of age, a parent or guardian must fill in
the box below with his/her name and date. Note: You may also be asked to
sign the form at the State Championships.
Name of Parent or Guardian (if under 18
yrs.)
Please keep track of your totals, BEFORE YOU SUBMIT THIS FORM.
You MUST be able to provide Paypal with the correct totals when
paying. For multiple entries in the same household, use your "Back"
button on your browser to bring this form back, then re-enter the appropriate
information and divisions for competitor #2. A thank you message will appear saying your entry
has been received each time this form is
submitted.
After submitting this form, you MUST then pay by PAYPAL by hitting the
"PAY NOW" button on the "THANK YOU" page that will come up
when this form is submitted. Failure to do so will negate your entry.
Paypal will accept credit cards, payments from your bank account, or Paypal
balances. It is secure and easy to do, but you must be registered, or register with Paypal
first, which is FREE. Paypal will then send you a receipt by email, which
we suggest you print and bring to State for confirmation of payment.