Philippines
2002 Visayan Martial Arts Sudlon Seminar
Registration Form
Please Print out and complete the details.
Mail this completed form to the address below together with your deposit,
to reserve your place. You will then receive a detailed itinerary.
Name:(Family)___________________________ First:___________________
M Initial:_____
Address(Street/Road):_____________________________________
City:____________________________
State:__________ Zip/Post Code:__________________
Country:________________________________
Date Of Birth: Day _____ Month_____ Year_________ Phone: (__________)_____________________
For our information we would like to know if you have previously trained in any
Filipino Martial Art or any other style.
Style And Rank:______________________ Date Of Rank:
Day_____ Month_____ Year:________
(or years of training)
Style And Rank:______________________ Date Of Rank: Day_____ Month_____
Year:_________
(or years of training)
Style And Rank:______________________ Date Of Rank: Day_____ Month_____
Year:_________
(or years of training)
Waiver of Liability: I hereby submit my application
for participation in this Martial Arts Seminar. I clearly recognise that a risk is
involved in participating in this seminar and related activities. Each participant attests
that he/she is physically fit to participate in the seminar(s). In consideration thereof,
I hereby waive, release, and forever discharge the VMA, Henry Jayme, John Russell, the
seminar host(s), seminar instructors, guest instructors, assistant instructors and all
participants, on behalf of myself, my heirs, my executors, my administrators and assigns,
of any and all claims, rights, or causes of action whatsoever for any damages or injuries
which may arise traveling to, participating in, returning from the seminar(s), or which
might arise thereafter, against any person or entity in any way connected with the
seminar. The parents and/or guardians of the applicant hereby request that this
application be accepted, and in consideration thereof, agree to indemnify and release all
members of the VMA, Henry Jayme, John Russell, the seminar host(s), seminar instructors,
guest instructors, assistant instructors and all participants, from all claims made or
which may be made on behalf of the applicant, for the aforesaid consideration. I
understand that all fees are non-refundable.
Participants must arrange and pay for their own travel from
their country of origin to the Philippines and Cebu and arrange and pay for their own
return travel from the Philippines and Cebu to their country of origin. Participants must
also arrange and to pay for their own accommodation during their travel to and from the
Philippines and Cebu, and any other accommodation and travel that is not involved with the
seminar in Sudlon proper. It is EXTREMELY IMPORTANT AND STRONGLY RECOMMENDED AND URGED
that all participants pay for their own medical and travel insurance's for the duration of
their trip. It is also EXTREMELY IMPORTANT AND STRONGLY RECOMMENDED AND URGED that all
participants inquire with their personal medical practitioner for their medical
practitioner's information, requirements and recommendations as to the participants
personal medical care and needs whilst traveling. The correct vaccinations are strongly
recommended to all persons traveling to the Philippines and participating in the seminar but
medical information must be first obtained from their own personal medical practitioner.
Photo/Video Release: I
hereby agree that any photographs and/or videos taken of me during my participation in
this seminar may be used for publicity or any other use seen fit by the VMA, Henry Jayme
or John Russell without any compensation to my parents, guardians, or myself. I hereby
waive any right I may have to inspect and/or approve any photographs and/or videos of
myself.
Seminar topics and content are subject to change without notification. |