2005 IKF
North American Classic
Amateur Kickboxing Championships

SAN SHOU
REGISTRATION FORM

Please be aware of the Required Cornerman & Trainers Registration and Event Pass Fee Due At Event Weigh-ins.
CLICK HERE!

• This registration form is for San Shou Rules only.
• ALL San Shou seeding will be done by OPEN DRAW.
  Each registered participant will be placed in their registered weight division on the Registration page. After weigh-ins, all registered fighters names will be placed into a bowl and the seeding will be determined by public draw.
• Print out this Form, Complete & MAIL to the IKF with your Finals Registration Fee of $50.00.
• Please include a HEADSHOT PHOTO (2" x 2") of yourself.
• Mail To: IKF, P. O. Box 1205, Newcastle, CA, 95658. ATTENTION: North American Classic Tournament.
• PLEASE PRINT NEATLY - Registration Forms "Without Fees" will be Disposed of.
• There are NO Registration Fee REFUNDS.

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1. FIGHTERS Name:_____________________________ HOMETOWN: ________________________
2. Have you ever fought as a pro fighter or been paid a fighters purse? ________
3. What REGION Are You From: _____________________________________________
4. Current Age: ____ & Birthday (month, day & year): ___/___/___
5. Height in Feet & Inches:____'____" - Weight in Pounds You Will Fight At: ______ Lbs.
6. FIGHTERS MAILING Address: ______________________________________
7. City: _______________________ State/Prov: _____________ Zip: _________
8. Country: __________________________________
9. FIGHTERS Phone Number: _____________________ Fax: _______________________
10. TRAINER: (SELF if you train yourself) ______________________ Gym Name: __________________
11. TRAINERS MAILING Address:_______________________________________________
12. City: _______________________ State/Prov: _____________ Zip: _________
13. Country: __________________________________
14. TRAINERS Phone:________________ Fax: ___________ e-Mail (If One):__________@____________
15. FIGHT RECORD: W=Wins, L=Loses, D=Draws, KO'S & TKO's=Knockounts or Technical Knockout.
16. W:___ L:___ D:___ KO'S/TKO's:___ AM BOXING, If any: W:___ L:___ D:___ KO'S/TKO's:___
17. Last Bout: Opponents Name: ___________________ Where:___________________________
    • Date of Bout:___/___/___ Result (Win or Lose, type of decision): _________________

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RELEASE FROM LIABILITY
This RELEASE of Liability is a Legal Contract binding upon You, ____________________________ The International Kickboxing Federation (Hereafter know as IKF), Wyndham Palace Resort and Spa and any and all companies, federations or organizations associates, officials, employees and staff of this event. Read It Carefully And Obtain Legal Assistance If You Do Not Understand It.

1: Voluntary Application. I, the undersigned, acknowledge and state that I have voluntarily applied to compete in the 2005 IKF Amateur North American Classic Kickboxing Championships on August 19th, 20th & 21st at the Wyndham Palace Resort and Spar in Orlando, Floridaa, USA.
2: Assumption of risk. I am aware & understand that in general, full contact fighting is a dangerous & hazardous activity, & in particular, the techniques & methods of this convention, all in which as a competitor in this competition, I shall be participating, is an extremely dangerous & hazardous event. I am voluntarily & of my own free will submitting an application to compete in this event with full knowledge & understanding of the hazards involved. I hereby consent & agree to completely accept alone any & all risks of injury or death, & I verify & confirm this statement by placing my initials here: _____
3: Release: In consideration for (a) being accepted as a competitor of the 2005 IKF Amateur North American Classic Kickboxing Championships, (b) being entitled to participate in activities conducted and sponsored by the IKF (International Kickboxing Federation and (c) being permitted to use facilities and equipment, whether owned or leased by The IKF and all associates, officials, employees, staff, Wyndham Palace Resort and Spa and fellow participants and trainers/coaches. I hereby agree that I, my heirs, distributees, guardians, successors in interest and legal representatives (collectively referred to as "Releasor") will not make a claim or file an action or suit against, sue, or attach the property of (a) the 2005 IKF Amateur North American Classic Kickboxing Championships, which would include The IKF or any and all of their officials, affiliated organizations, and/or their directors, officers, employees, agents or managers, fellow participants, trainers, Wyndham Palace Resort and Spa or any and all of their affiliated organizations, and/or their directors, officers, employees, agents or managers and (b) any or all manufacturers, distributors, wholesalers, suppliers and/or retailers of the facilities and equipment I will use in connection with any and all activities conducted and/or sponsored by The IKF and Wyndham Palace Resort and Spa and any and all of these companies, federations or organizations associates, officials, employees and staff (collectively referred to as the "suppliers"), The Suppliers and shall collectively be referred to as "Releasees" for damages, injury, emotional distress claims, bodily injury claims, and punitive damages, whether known or unknown, foreseen or not, due to or resulting from the acts, conduct, negligence, or misfeasance of, or omissions or failures to act by, the Releasees, or any of them. (a) being accepted as a competitor of the 2005 IKF Amateur North American Classic Kickboxing Championships, (b) being entitled to participate in activities conducted and sponsored by the IKF and Wyndham Palace Resort and Spa and (c) being permitted to use facilities and equipment, whether owned or leased by The IKF and all associates, officials, employees, staff or by Wyndham Palace Resort and Spa or by fellow participants and trainers/coaches. I hereby agree that I, my heirs, distributees, guardians, successors in interest and legal representatives (collectively referred to as "Releasor") will not make a claim or file an action or suit against, sue, or attach the property of (a) the 2005 IKF Amateur North American Classic Kickboxing Championships, which would include The IKF or any and all of their officials, affiliated organizations, and/or their directors, officers, employees, agents or managers, fellow participants, trainers, and (b) any or all manufacturers, distributors, wholesalers, suppliers and/or retailers of the facilities and equipment I will use in connection with any and all activities conducted and/or sponsored by The IKF, Wyndham Palace Resort and Spa and any and all of these companies, federations or organizations associates, officials, employees and staff (collectively referred to as the "suppliers") and Wyndham Palace Resort and Spa and any and all of these companies, federations or organizations associates, officials, employees, staff. The Suppliers and shall collectively be referred to as "Releasees), for damages, injury, emotional distress claims, bodily injury claims, and punitive damages, whether known or unknown, foreseen or not, due to or resulting from the acts, conduct, negligence, or misfeasance of, or omissions or failures to act by, the Releasees, or any of them.
4: Application of State Law: In further consideration of (a) being accepted as a competitor in the 2005 IKF Amateur North American Classic Kickboxing Championships, (b) being entitled to participate in activities conducted and sponsored by The IKF, Wyndham Palace Resort and Spa and any and all of these companies, federations or organizations associates, officials, employees and staff, and (c) being permitted to use facilities and equipment, whether owned or leased by The IKF, Wyndham Palace Resort and Spa and any and all of these companies, federations or organizations associates, officials, employees and staff, I hereby agree that this Release from Liability shall be interpreted under and construed in accordance with the Florida State law only, without the benefit of and fully disregarding all Florida State conflicts of laws provisions, so that any and all disputes, contentions, disagreements or controversies arising from or related to (a) this Release from Liability, (b) the application for acceptance into the Challenge, or (c) my participation in any and all activities conducted or sponsored by The IKF, Wyndham Palace Resort and Spa and any and all of these companies, federations or organizations associates, officials, employees and staff and Shall be interpreted under and in accordance with only the Florida State law regardless of my domicile or residency; and that the only court in which an action or suit may be brought in connection with the foregoing shall be the court of original jurisdiction of the State of Florida. Further, I waive any right I may have to assert the doctrine of forum non conveniens or similar doctrine or to object to venue with respect to any proceeding brought in accordance with this Release, and I stipulate that the Florida courts shall have in personam jurisdiction and venue over me for the purpose of litigation any dispute, controversy, or proceeding arising out of or related to this Release, The IKF, Wyndham Palace Resort and Spa and any and all of these companies, federations or organizations associates, officials, employees and staff.
5: Health Advisory and Condition. I hereby acknowledge and understand that participating in this event involves extremely strenuous physical activity and heavy physical contact, and that I have been advised to consult a physician before commencing and undertaking such activity. I hereby represent that, to the best of my knowledge, I am in good physical health and condition, sufficient to undertake this dangerous and hazardous competition.
6: Knowing and Voluntary Execution. I hereby declare that I have read this Release from Liability, and that I fully understand the meaning and importance of its contents. I acknowledge that this Release is a binding contract among The IKF, Wyndham Palace Resort and Spa and any and all of these companies, federations or organizations associates, officials, employees, staff and myself, and that under this contract I am releasing The IKF (International Kickboxing Federation) Wyndham Palace Resort and Spa and any and all of these companies, federations or organizations associates, officials, employees and staff from all liability for claims I may have against them. I further declare and represent that I am at least 18 years of age, that I have full legal capacity to be bound by this contract, and that I am signing this contract of my own free will and accord.

Executed at _________________AM/PM, on this _________day of ____________________, in the year 2005.
Applicant If OVER 18 Sign Below - If Not See Below

Signature: _________________________________________ Print Name: _____________________________
UNDER 18 FIGHTER - PARENTAL WAIVER
I, ____________________________ (parent/guardian) the parent and guardian of ___________________________ (minor fighters name) hereby agree to the above RELEASE FROM LIABILITY on behalf of the minor named herein and bind myself and said minor to the terms and conditions of this waiver and release. I have legal capacity and authority to act for and on behalf of the minor name herein, and I agree to indemnify and hold harmless the persons or entities mentioned above for any claims or liabilities assessed against them.

Signature: _________________________________________ Print Name: _____________________________