Battle of Ontario - Pre-Registration Form Deadline October 13, 2007
Don, Marj, Terry or Donna Benoit can be reached to asist you with any Questions you may have regarding Battle of Ontario at: Tel: 1-705-522-4413  (5:00-8:00pm)
Fax: 1-705-523-5840 or e-mail us at benoitma@isys.ca		 <IMG SRC=

Mailing Instructions:
  1. Print this form
  2. Complete all applicable sections of Pre-Registration Form.
    Note: Competitors are competing as of their age on the day of the tournament
  3. Attach Money Order for total amount on Pre-Registration Form
  4. Mail Pre-Registration Form and Money Order to above address to:
    M. Benoit
    1352 Marcel Street
    Sudbury, Ontario P3E 4G3
    *Payable before October 13, 2007 *

Name:   DOB:      /    /    AGE:   Sex   M  /  F
Address:  
 		 City:  
 
Province/State:   Counrty:   Postal Code:  
Telephone: (         )  E-Mail:  

School Name:
   Rank:  
School Address:  
 
Instructor Name:  

Team Registration
Team Name:   Team Captain:   DIV #  
Cost per Team: $30 CDN (Pre-Registered) or $45.00 CDN (at the door)

Division Pre-Registration
Kata - Open/Musical DIV # *Competitor Must Provide Own Stereo Equipment*
Kata - Traditional DIV #  
Weapons DIV #  
Weapons - Open/Musical DIV # *Competitor Must Provide Own Stereo Equipment*
Weapons - Traditional DIV #   
Sparring DIV # *Weight (lbs):
Self-Defense DIV #  
Pre-Registration Costs: $40 CDN for 1 or 2 Divisions & $5.00 CDN for each additional division
Registration Costs at the Door (8:00 am): $40 CDN for 1 Division & $5.00 CDN for each additional division
Spectator Tickets: $7.00 CDN for Adults (18 and older)
FREE for 5 & Under when accompanied by an adult.

I agree to assume full responsibility for any and all damage, injuries or losses that I may sustain or incur, if while attending participating in the Battle of Ontario Open Karate Championships. I hereby waive all claims against the promoters, operators, sponsors, advitisers, tournaments agents, volunteers and Benoit's Martial Arts. I fully understand that any medical attention provided will be on a First-Aid basis only. In addition, any media coverage or photographs taken of me may be used without financial compensation payable to myself.
Signature:  
  		Parent/Gaurdian:   Date:   /      /