YMAF MARTIAL ARTS SEMINAR

Chi Gerk Seminar: Online Registration Form

Register by 09/12/2020 to reserve your spot.

• Name First Last
• Address Street Address or P.O. Box
  City Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware D.C. Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State Zip Code
• Phone Number () - Email Address



• Will you be able to attend?			Totals
  	Yes, I will be attending!
  	I would like to donate at least $50 and recieve a T-shirt.
  	Please accept my donation.	Donation Amount:	$

• Select T-shirt size (one per registration with donation of $50 or more)
  Registration must be recieved by 09/07/2020 in order to get a free T-shirt.
  small	medium	large	x-large	xx-large




• Waiver of Liability

  I hereby indemnify and waive all claims against YMAF, its agents, directors, sponsors and representatives for any injury that I (or my minor child or pet, in the event of parental permission) may suffer in this event. I attest that I am physically fit and able to participate in this event. I acknowledge and understand that this event involves a strenuous activity. I also understand that I am responsible for any injury my pet shall cause before, during and after event, while on event premises.

  I agree to these terms and conditions.