TOURNAMENT REGISTRATION FORM

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0 height="100%"><tr> <td valign="top" width=200 BGCOLOR="#003333" TEXT="#F7F7FF" background="3d4d4c00dduajq.gif"> <div> <TABLE BORDER="0" CELLPADDING="2" CELLSPACING="0" WIDTH="95" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP HEIGHT= 46 WIDTH="91"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="46" ALIGN="bottom" WIDTH="91" HSPACE="0" VSPACE="0"></tD> </tR> </TABLE></div> <bR> <bR> </td> <td valign="top" BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <FONT SIZE="5" COLOR="#FF6600" FACE="Arial" >WORLD KARATE UNION HALL OF FAME</FONT> |   <A HREF="index.htm" TARGET="_top" TITLE="WORLD KARATE UNION HALL OF FAME"><U>home</U></A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="ABOUT US"><U>ABOUT US</U></A>   |   <A HREF="id18.htm" TARGET="_top" TITLE="UPCOMING EVENTS"><U>UPCOMING EVENTS</U></A>   |   <A 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TITLE="CONTACT US"><U>CONTACT US</U></A></div> <div> <IMG SRC="04558020.gif" border=0 width="600" height="2" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <bR> <div> 10TH ANNUAL WKUHOF KARATE TOURNAMENT</div> <div> The Chateau at Camelback</div> <div> Tannersville, Pa. 18372</div> <div> Sunday, June 29, 2008</div> <bR> <div> NO CHECKS ACCEPTED DAY OF EVENT</div> <bR> <div> REGISTRATION FORM</div> <bR> <bR> <div> PERSONAL INFORMATION                                     SCHOOL INFORMATION</div> <bR> <div> <TABLE BORDER="2" CELLPADDING="2" CELLSPACING="1" WIDTH="622" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP HEIGHT= 56 ><NOBR><div>                                               </div> <bR> <div> Last Name:...............................................Instructor Name:.......................................................</div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 53 ><NOBR><bR> <bR> <div> First Name:....................................................................School Name:.......................................</div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 53 ><NOBR><bR> <bR> <div> Street Address:..........................................Street Address:.......................................................</div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 35 ><NOBR><bR> <div> City:.............................State:......................Zip:...............City:.........................State:..............Zip:.........</div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 35 ><NOBR><bR> <div> Country:..........................................................................Country:............................................................</div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 35 ><NOBR><bR> <div> Telephone:....................................................................Telephone:.........................................................</div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 35 ><NOBR><bR> <div> Age:...............................D.O.B.......................Height:...........................................Weight:.......................</div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 35 ><NOBR><bR> <div> Rank:........................................................Martial Arts Style:.......................................................</div> </NOBR></tD> </tR> </TABLE></div> <div>  Events of entry: ___________Weapons: ____________Forms:______________Sparring</div> <div> Padded  Weapons :_____________</div> <div>   Competition Level:  Age:____Beginner:_______Intermediate:______Advanced:________</div> <div>                                      Black Belt:_______________Executive:___________</div> <bR> <div> Entry fees (non refundable) ______$35.00 ALL EVENTS ( before June 20, 2008)</div> <div>                                               ______ $40.00 ALL EVENTS ( after June 20, 2008 )</div> <div> $5.00 Discount WKURS Ratings Members. Member ID Number:____________</div> <div> Spectator Fees: ________$5.00 ( 12 yrs + up)____________$3.00 ( 5-11yrs.)</div> <div> Make checks or Money Orders payable to: World Karate Union Hall Of Fame</div> <div>                                           437 Sabol Road</div> <div>                                                         Stroudsburg, Pa. 18360 </div> <div> Telephone/fax: 570-992-3458 or e-mail: tasekat@epix.net</div> <bR> <div> ****************************************************************************************************************<FONT SIZE="3" COLOR="#111111" FACE="Arial" >*********</FONT></div> <div> LIABILITY OF WAIVER</div> <div> ( If downloading, this must be returned, signed with application! )</div> <bR> <div> In consideration of your acceptance of my registration, I do hereby for myself and my heirs, executors and administrators waive, release and discharge forever any and all rights and claims for damages which I may have in connection with the tournament, have or incur and those which may be accrued to me against the </div> <div> WKUHOF ( World Karate Union Hall Of Fame), Frank and/or Kathi and/or Trevor Tasetano, the promoters</div> <div> and/or their heirs, the 10th Annual WKUHOF Karate Tournament, the Chateau at Camelback and/or their</div> <div> employees, the arbitrators, and/or leasees of premise, my personal representatives, assigns, heirs guardians and/or next of kin for any/all damages and any claim or demands therefore on account of injury to the person or property or resulting in the death of the undersigned, whether caused by negligence of releases, accident or otherwise while the undersigned is in or upon the restricted area and/or competing in, observing or working for, or any other purpose participating in this event. I also certify that I have NO MEDICAL CONDITION(S) that may or will cause injury to myself or others by my participation in the 10th Annual WKUHOF Karate Tournament. I also waive my rights to any compensation in the event my picture is</div> <div> used for publicity in connection with the tournament.</div> <bR> <div> NAME:__________________________________SIGNATURE:_____________________</div> <div> PARENT/GUARDIAN:_______________________________DATE:________________</div> <bR> </td> </tr></table></body>