Important Tournament Dates….

Saturday,      September 11:        Karate Tournament, Mandeville, LA (Pelican Park, White Gym)

Saturday,     October 16:                     Louisiana State Championship Tournament, Ruston, LA

 

Mandeville……………

 

 

 

 

 

 

 

 

2004 Battle of the South

Saturday, September 11^th

Mandeville, La – Pelican Park White Gym

 

 

PLEASE NOTE........

Some division times were originally listed incorrectly (re-published 8-9-2004)

 --------------------------------------------------------------------print and cut here---------------------------------------------------------------------------

MKTC Application to Compete – 2004 Battle of the South

September 11^th, 2004   -   Pelican Park – White Gym

$35: Forms & Sparring       $5: Weapons

$5 discount with current U.S. Karate Alliance membership card

 

Events (circle each):       Sparring                      Forms                    Weapons

Name:____________________________________ Age:____ date of birth:__________ Rank:________________

Address:_________________________________________ City:___________________ State:____ Zip:________

 

Notice: this agreement contains indemnity and release provisions.

In submitting said application, the undersigned hereby gives permission for the contestant to participate in said Battle of the South to be held at Pelican Park, Mandeville, Louisiana on Sept 11, 2004. Acting for myself, or as the parent or legal guardian for the contestant, I do hereby assume all risk of injury to said contestant while participating in and traveling both to and from said Battle of the South, and acting for myself, my heirs, personal representatives and assigns, do hereby release Pelican Park, Joe Dupaquier Jr., the tournament directors, United States Karate Alliance, and associations, the officers, agents, employees and representatives of said organizations and any and all competitors and fellow participants, individually and collectively, from any liability (now and forever). As a parent or legal guardian, I agree to indemnify any such organization for any loss or expense by reason of any claim by child or ward.

 

Date_________ Signature of Contestant (or Guardian if under 18) __________________________________