Referee – Registration
*Referees who bring in their own ipads with iPoomsae pre-loaded for the Competition Poomsae will receive additional $10. A total of 9 ipads will be needed.
Be sure to fill out the USAT Referee Certification Seminar application or register online if attending on January 20, 2018.
I hereby submit this registration and liability waiver form to participate in the Yushen Lai’s Invitational Taekwondo Championship. I certify that the above information is true and correct and hereby release, discharge and waive any and all responsibility of the CSU, Dominguez Hills, Yushen Lai’s Taekwondo Academy, Tournament Committee, Referees, Instructors, and other competitors from liability for any injury, including death, and for damage to or loss of property which may be suffered by myself arising out of, or in any way resulting from or attributable in whole or in part to my traveling to, training for, being coached in, using any sports equipment in, or participating in the said event. As a competitor or parent/legal guardian of the competitor, I give consent to any x-ray exam, medical, chiropractic, dental or other treatment(s) deemed necessary for the safety and welfare of the contestant. I understand that this authorization is given prior to any diagnosis, treatments or hospital care being required, but is given to provide the medical/chiropractic/dental staff authority to render care as deemed advisable. In the case of minors, it is understood that efforts shall be made to contact the undersigned prior to rendering treatment, but treatment will not be withheld if the undersigned cannot be reached. I understand that in case of injury, only basic first aid will be made available on site, and that I am fully responsible for any and all resulting medical or other expenses. I release all rights to any photographs, video, audio, electronic images in which I or the minor appear and allow it to become the property of YLITC without compensation to be used, published, reproduced, distributed and other uses free of all claims and/or damages which may be incurred.