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Call or email for limited time Specials and Gift Certificates.

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   Advanced BKJ's

Brazilian Jiu-Jitsu Tournament

Pre-Registration

PRE-REGISTRATION FORM (Deadline coming soon)

Fees:  Pre-Registration = $35 to compete in one event, $40 to compete in everything (gi, no gi, etc)

            Day of the event = 50$ to compete in one event, 55$ to compete in everything (gi, no gi, etc)

Please fill out ALL of the above information and ALL of the events that you plan on fighting in.  Include these, along with your waiver when mailing forms out.  It is also very important to email this information when using PayPal but your waiver still has to be mailed or faxed.

MEN’S - WHITE BELT

_____ 150 & Under (Flyweight)

_____ 151-170.9 (Lightweight)

_____ 171-190.9 (Middleweight)

_____ 191-210.9 (Light Heavyweight)

_____ 211 & Above (Heavyweight)

MEN’S - BLUE BELT

_____ 150 & Under (Flyweight)

_____ 151-170.9 (Lightweight)

_____ 171-190.9 (Middleweight)

_____ 191-210.9 (Light Heavyweight)

_____ 211 & Above (Heavyweight)

MEN’S - PURPLE BELT & ABOVE

_____ 150 & Under (Flyweight)

_____ 151-170.9 (Lightweight)

_____ 171-190.9 (Middleweight)

_____ 191-210.9 (Light Heavyweight)

_____ 211 & Above (Heavyweight)

Women's Skill Levels May Be Combined

WOMEN’S WHITE BELT DIVISIONS

_____ 135 & Under (Lightweight)

_____ 136 & Over (Middleweight)

Women's Skill Levels May Be Combined

WOMEN’S BLUE AND ABOVE BELT DIVISIONS

_____ 135 & Under (Lightweight)

_____ 136 & Over (Middleweight)

TEEN GI DIVISIONS (Ages 15, 16, & 17):

____ Approximate weight

I, (print name) ______________________________________,

the undersigned hereby release Advanced Boxing, Kickboxing, & jiu-Jitsu (Advanced BKJ), Butch Hiles, and any and all other persons associated with this event in any capacity, from any and all liability due to injuries that may incur as a result of my attendance and/or participation at this event. Furthermore, I hereby waive any compensation whatsoever for the use of pictures or video production of myself, utilized by those associated with this event, for any profit-making at anytime.   I agree to indemnify, defend and hold harmless all the above named parties from any liability.  I clearly understand that the fighting aspect of this sport and competition involves bodily contact. Submission grappling is a very dangerous sport. The organization sponsoring this training will not assume financial or other responsibilities for injuries or illness suffered from or related to this competition, nor will they be responsible for any loss to attendees as a result of damages of their person or personal items through fire, theft or other causes. Injuries to joints, bones and muscles are possible when you grapple in this type of competition. Serious injuries are possible due to the nature of the activity. Grappling is an extremely taxing sport, and by signing below you indicate that you are in adequate physical condition to engage in this type of activity and accept responsibility for injuries, etc. that may occur.  I have read, understand and agree to abide by the rules associated with the Advanced BKJ Jiu-Jitsu Tournament and assume all responsibility and any associated liability for infringement of such rules. Additionally, I am fully aware of my personal medical condition and hereby certify that I am mentally and physically fit to compete at the Advanced BKJ Jiu-Jitsu Tournament.  

__________________________________________________

Competitors Signature Date

__________________________________________________

Signature of parent / guardian who assumes complete responsibility (if under the age of 18)

Fax:  14198310444

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