Our MOJJJO Patriotic Tribute & Ceremony of the Ashes shall conclude at The Memorial of the Marines (Iwo Jima Statue).

Similar documents
2014 Sergeant Major Mayfield s

Jacksonville Commons Recreation Center, 100 Recreation Loop, Jacksonville, North Carolina 28541

2016 RAINIER CUP JUDO CHAMPIONSHIPS

2014 Indiana State Championships

2010 Furniture City Open Sanctions: USJF # Pending

2019 Washington State Judo Championships

Denver Judo Spring Tournament

Obukan Judo Dojo Inc.

Barstow Judo Club Invitational Judo Tournament

Treasure Valley Judo Club Tournament USJF Sanction # Saturday April 15, 2017 Capital High School 8055 Goddard Rd. Boise, Id.

Mail applications to: Richard Imamura 602 W. Princeton Fresno, CA 93705

60th Annual Obukan Judo Shiai and Kata / Onchi Sensei Memorial Tournament Sponsored by Obukan Judo Dojo, Inc. Sanctioned by the USJF (# )

North Bay Developmental Shiai

62nd Annual Obukan Judo Shiai and Kata / Onchi Sensei Memorial Tournament Sponsored by Obukan Judo Dojo, Inc. Sanctioned by the USJF (# )

17 th Annual Denver Classic Judo Championships

HUDSON JUDO YUDANSHAKAI RANK PROMOTIONAL TOURNAMENT

2012 Indiana Open State Championships. Hosted By

Tournament Headquarters: La Quinta Inn NE Holman PORTLAND, OR Chairmen: Blane Bellerud and Tim Ribeiro

AKIYA JUDO CHAMPIONSHIP SHIAI AND KATA COMPETITION SCHEDULE: Saturday, April 14, 2012

2013 NIKKEI GAMES JUDO SHIAI & KATA TOURNAMENT Sponsored by the Nikkei Games Coordinating Council

United States Naval Academy Judo Team Senior Invitational USA Judo Sanction # Saturday, March 2, 2019

Kaizen Judo Dojo 11 th Anniversary Shia Sanction # Saturday, October 6, 2018 Syracuse High School 665 S W. Syracuse, UT 84015

* * * USA Judo E Level Tournament * * *

2018 Washington State Judo Championships

Bay Area Judo Tournament

America s Cup Judo Championship 2018

2015 PRINCETON JUDO INVITATIONAL Sanctioned by USJF #

$40 - Novice and Black Belt Divisions. DIRECTOR: Jon Bertsch

NORTH COAST CHAMPIONSHIPS. Church on the North Coast Gym 4125 Leavitt Rd. Lorain, Ohio 44053

SUNDAY, MARCH 26, 2017

The 2019 West Clovis Senseis Memorial Judo Tournament

Cherry Blossom Open XXV

Saturday, Oct. 29 Pittsburgh Oliver High School

Annual Tournament Texas Judo All Star Event Brown Belt State Championship

EAST BAY INVITATIONAL JUDO TOURNAMENT

HUDSON JUDO YUDANSHAKAI RANK PROMOTIONAL TOURNAMENT

2018 CENTRAL COAST YUDANSHAKAI CENCO CUP TEAM TOURNAMENT

2012 Rainier Cup Judo Championships

Hanabi Halloween Classic 2018

Universal Judo 2018 FALL CLASSIC Judo Championships (USA Judo Sanction # 16664)

Hui-O-Judo Beltsville and College Park Judo Club

The USA CUP. International Junior & Cadet World Roster Point Tournament. National Ranking Points: Cadet & Junior - 3 for 1st, 2 for 2nd, & 1 for 3rd

10 th Annual Denver Classic Judo Championships

The Becerra Judo Challenge

1 st Set 1 st Set 1 st Set 2 nd Set 2 nd Set 2 nd Set 3 rd Set

UAA Judo and Jiu Jitsu Presents

YOU NEED TO BRING YOUR OWN BLUE AND WHITE BELTS!

2016 FRESNO JUDO CLUB INVITATIONAL

Referee Clinic. Hui-O-Judo Beltsville Shufu Judo Yudanshakai United States Judo Federation. All levels of referees should attend this clinic!!

Lima Family YMCA - Lima, Ohio

2017 Texas Judo Inc. NCJA Southwest Regional Collegiate Championships

MARYLAND OPEN CHAMPIONSHIPS Saturday, January 28, 2017

PRESENTS THE. 23nd ANNIVERSARY OF THE ROCK & ROLL CAPITAL OF THE WORLD JUDO TOURNAMENT. Saturday September 15th, New Venue

Gunnery Sergeant Ernest C. "Judo" Jones Open Judo Championships

2018 Budokan Dojo Tournament Sponsored by Budokan Dojo & Japanese Cultural and Community Center of Washington Sanctioned by the USJF #TBD

RPI s Annual Spring Judo Tournament

2013 Washington State Championships

Midwest Collegiate Judo Championships

21st ANNIVERSARY OF THE ROCK & ROLL CAPITAL OF THE WORLD JUDO TOURNAMENT

Land of Lakes Open Judo Tournament - October 13, 2018

EVERGREEN STATE OPEN JUDO CHAMPIONSHIPS

18th Annual USJF National Kata Conference August 2-4, 2018 Honolulu, Hawaii

THE AKIYA MEMORIAL JUDO TOURNAMENT

GRANITE STATE FALL JUDO CHALLENGE Sanctioned by: USA Judo #

Iowa State Judo Championships

Mose Woodson Judo Classic

United States Naval Academy Judo Club Senior Invitational. Saturday, October 4, 2008

Land of Lakes Open Judo Tournament - October 13, 2018

2018 O. J. Helvey Kentucky State Judo Championships

FEB 25 th & Feb 26 th, 2017

2019 Texas Judo Inc. NCJA Southwest Regional Collegiate Championships

JUDO CHAMPIONSHIP DALLAS INVITATIONAL. November 22, th Annual USA JUDO SENIOR D LEVEL & JUNIOR C LEVEL TOURNAMENT HOTEL NAME COMPETITION VENUE

35th Annual Oil Capital Judo Classic

MVJ 14 th Invitational Round Robin Judo Tournament.

2019 Ohio Judo Championships March 31th, 2019

$ FIRST PLACE PRIZE FOR OLYMPIC DIVISIONS $ SECOND PLACE PRIZE FOR OLYMPIC DIVISIONS $ THIRD PLACE PRIZE FOR OLYMPIC DIVISIONS

Saturday August 24, 2013 $45 Pre Registration Fee Pre Register By August 10, 2013 For Current info:

Bluffton University 1 University Drive Bluffton, Ohio 45817

2018 Texas Judo Inc Junior, Senior, Masters and Kata Championships

2011 Michigan State Games Judo Sanction: USA Judo #

2013 O. J. Helvey Kentucky State Judo Championships

OCEAN STATE INTERNATIONAL 2015

Jack Hatton and Harun Bogdanic Judo Clinic USJF Sanction Number: #

OHIO JUDO, INC. presents the. March 18th, 2017

SATURDAY DECEMBER 8 th, 2018

Maumee Bay Classic Sanction # Saturday, October 20, 2018

2009 GREAT LAKES OPEN JUDO CHAMPIONSHIPS Sanctions: USJF #

JOINT CLINIC WORKOUTS January 12, :00 AM - 4:00 PM. USJF Sanction #

OCT 27, 2018 FLORIDA JUDO RANKING

High Mountain Open Judo Championship McCall, Idaho

23rd Annual Go Shibata Memorial Texas Judo Inc. All-Star Event

1 st Sandia Judo Winter Open

2018 Nanka Spring Elite Training Camp Sponsored by USJF / Nanka Development USJF Sanction #

52nd Annual Dallas Invitational Judo Championships

Universal Judo Club Training Camp

OCEAN STATE INTERNATIONAL 2012

53rd Annual Dallas Invitational Judo Championships NOVEMBER 17TH, 2018 IRVING CONVENTION CENTER IRVING, TEXAS

USA DIVISIONS JUNIOR. Special

September 22, Contact Tournament will be held in Providence Rhode Island

2019 Rebel Judo Invitational

Transcription:

Dear Patriots, Ladies, Gentlemen and Children: MOJJJO (United States Military Outreach Judo & Jiu Jitsu Organization (MOJJJO), Incorporated, Dba., Mayfield s Martial Arts Academy, aka THE ACADEMY (a non-partisan, non-denominational, and non-profit 501.(c).3 corporation) respectfully requests your presence at our February 22-24, 2013 Annual Patriotic Tribute and Sergeant Major Mayfield s 8 th Open Judo Championships & 4th National USA Judo Referee & Coaches Examination and Certification. MOJJJO will be receiving names of your Patriot to be included in the Patriotic Tribute and Ceremony of the Ashes. Following the local Patriotic Tribute & Ceremony of the Ashes, MOJJJO will respectfully participate in the Wreath Laying Ceremony at the Tomb of The Unknowns at the Arlington National Cemetery, Arlington, Virginia at exactly 12:15 pm on February 24, 2013, to Honor our fallen Patriots for their Service. To all those now resting with the Creator, the Angels, and Saints, we say to each of them, Job Well Done! and we bid them Fair Winds and Following Seas! MOJJJO, Inc. will collect the name(s) on a small piece of paper of the person or persons that you want to have included in the Patriotic Tribute and Ceremony of the Ashes. These offerings will be burned and reduced to ashes. The ashes will be consecrated, carried to the Arlington National Cemetery and cast to the winds, as an integral piece of the Ceremony of the Ashes, at various historical monuments and sites in the Arlington, Virginia and Washington, DC memorial gardens. Our MOJJJO Patriotic Tribute & Ceremony of the Ashes shall conclude at The Memorial of the Marines (Iwo Jima Statue). Go to our websites at: www.mojjjo.com and www.mayfieldsmartialartsacademy.com. Whatever name or names that you can contribute, to help us accomplish our MISSION of obtaining 58,158 sponsors for each of that same number of names on THE WALL honoring the fallen Vietnam Veterans would be greatly appreciated. We humbly ask that you consider contributing whatever you can afford per each named to assist MOJJJO, Inc. in raising $3,000,000.00 to conduct a four-year, in-depth, research study into the effects and a possible relief for persons affected by Combat Related PTSD. In conclusion, MOJJJO, Inc. asks each of you to get the word and the check books out and support our veterans and Active Duty by helping MOJJJO. Also, no matter where you may be at exactly 12:15 pm on Sunday, February 24, 2013, please light a small Birthday Cake Candle and let it burn until it extinguishes itself. During that time, the Wreath Laying Party will try to have completed their Wreath Laying Ceremony at The Tomb of The Unknowns for the 2013 Patriotic Tribute & Ceremony of the Ashes. CHILDREN ARE NOT AUTHORIZED TO LIGHT CANDLES WITHOUT DIRECT PARENTAL OR ADULT SUPERVISION.

SCHEDULE OF EVENTS February 22, 2013 5:00 pm: Registration for Referee and Coaches Examinations at Host Hotel 6:00 pm: Referee and Coach Classroom time and Registrations and weigh-ins. (International Judo Federation (IJF) Referee Rules Books will be available for ($5.00) in order to cover the administrative handling expenses). 9:00 pm: Classroom time terminates. Good luck! February 23, 2013 8:00 am: Tournament Registration and Weigh-Ins 9:00 am: Referee and Coach Meeting on the mat & Morning Coffee 9:30 am: Depart for Patriotic Tribute & Ceremony of the Ashes. 9:59 am: Invocation: The Honorable Sheriff Ed Brown. 10:00 am: (Sheriff Brown and Honored Bahamian Guest) Step OFF! 10:45 am: Return to gym. 11:00 am: Opening Ceremony 11:30 am: Commence Competition and terminate all Registrations and Weigh-Ins. Note: MOJJJO will award medals as soon as the divisions are tallied. MOJJJO will also have a photographer on hand for awards and other photos for your convenience. 18:00 pm: You are invited to join MOJJJO at the Host Hotel for an informal mixer with food, music, and drinks. 12:01 am: Sergeant Major and Mrs. Mayfield and Wreath Laying Party depart Jacksonville for Arlington, VA. February 24, 2013 12:15 pm: The Wreath Laying Ceremony and Changing of the Guard at the Arlington National Cemetery in Arlington, VA.at the Tomb of the Unknowns (Tomb of the Unknown Soldier). WE WILL SEE YOU ON SUNDAY, FEBRUARY 24, 2013 AT 12:15 PM AT THE TOMB OF THE UNKNOWNS. MAY GOD BLESS EACH ONE OF YOU, YOUR FAMILIES, YOUR LOVED ONES, and THE UNITED STATES OF AMERICA! Thank you for participating, for setting the proper example for our children to emulate, and for being proud to model Patriotism and/or Citizenship.

Please send all tributes (your loved one s name, etc.) and contributions: MOJJJO, Inc. P. O. BOX 12275 Jacksonville, North Carolina 28546-2275 Or online at: www.mojjjo.com or www.mayfieldsmartialartsacademy.com via PayPal Your tax-deductible contributions will be used to directly assist Military personnel and their families. in the following areas: 1. PTSD & TBI & Muscular Sclerosis Research (Combat Related) 2. Adopting American Amateur Athletes Programs 3. Coach Takemori Grassroots Developments Fund 4. MOJJJO Disaster Relief (Hurricane Sandy) 5. Museum of the Marines 6. Military Order of the Purple Heart 7. Growth & Development

MOJJJO United States Military Outreach Judo & Jiu Jitsu Organization (MOJJJO), Incorporated, P. O. Box 12275, Jacksonville, North Carolina 28546-2275, (910) 355-9206 (office), (910) 355-9111 (fax), (910) 330-1352 (cell), Email: MOJJJO_Sensei@hotmail.com and SergeantMajor_of_Marines@hotmail.com, Websites: ww.mojjjo.com and www.mayfieldsmartialarttsacademy.com 2013 Sergeant Major Mayfield s 8th Open Judo Championships & Patriotic Tribute (Honoring the late Captain Doug Berliner, USMCR) & 4th National Referee and Coach Examinations and Certifications and Clinics Jacksonville Commons Recreation Center, 100 Recreation Loop, Jacksonville, North Carolina 28541 Sanctioned by: USA Judo # 2013-03- 02 Tournament Director(s): Mrs. D. M. Maisha Mayfield Operations: Mr. Kurt Tamai (Shufu) Date(s): Friday, Saturday, and Sunday, February 22, 23, & 24, 2013. Tournament date is February 23, 2013 Entry Fees: All Divisions are thirty- five ($35.00) and fifteen ($15.00) per each additional division. Junior and Senior athletes who are able to show proof that they are on the current USA Judo Elite Athlete Roster will be exempt from entry fees. Uncontested Competitors will receive medals. However, all efforts shall be made to create at least two (2) matches, so long as the directors, coaches, and/or parents agree. Kata entry fees are forty ($40.00) dollars, plus ten ($10.00) for additional katas. If uke becomes the tori, this constitutes an additional kata and the ten ($10.00) fee will apply. Coaches Exam/Clinic Fees are Fifty- five ($55.00) dollars, payable to MOJJJO. Seventy ($70.00) dollars is payable to USA Judo for certification and ID Card. Payment: Payment may be in cash, check, money order, or certified bank drafts, or credit cards. Admission: Free Registration: Registration for Referee and Coaches Clinics may be submitted at the Mayfield s Martial Arts Academy, 208- B Henderson Drive, Jacksonville, NC 28540 on Friday, February 22, 2013 from 5:00 pm until 6:00 pm. Competitors may register at the venue on Saturday, February 23, 2013 from 8:00 am until 10:00 am for Juniors, and from 8:00 am until 11:30 am for Masters and Seniors. Weigh- In: Weigh- in will be conducted at the time the competitor registers. Requirements: All competitors are required to be members of either, USA Judo, USJF, or USJA, or possess a Letter of Authorization to Compete/Participate (In English) from their Federation. All Applicants for USA Judo National Referee and/or Coach Certifications are required to have USA Judo memberships. Applications for each of the above organizations will be available at our MOJJJO Registration Desk. Schedule of Events: 9:00 am 9:30 am REFEREE & COACHES MEETING & RULES CLINIC FOR APPLIICANTS (On the mat!) 10:00 am 11:00 am PATRIOTIC TRIBUTE TO OUR MILITARY, OUR WOUNDED WARRIORS, THEIR FAMILIES & American Amateur Athletes. 11:00 am 11:30 am Opening Ceremony 11:30 am COMPETITIONS COMMENCE (Kata & Shiai) HOTEL: Sleep Inn Jacksonville 910/478-0099. Special $70.00 Judo rate. Call early, rooms will go fast. Sponsored by: MOJJJO: (United States Military Outreach Judo & Jiu Jitsu Organization (MOJJJO), Inc.,is a Non- Governmental Organization (NGO) 501. C. (3) non- profit corporation in North Carolina that is registered with the North Carolina Secretary of State (NCSOS) and the Internal Revenue Service (IRS).

Contest Rules: IJF (International Judo Federation) Rules will govern this competition. The Head Table must immediately be made aware of withdrawals. Those who perform prohibited acts (regardless of age or experience) are subject to automatic Hansokumake (Disqualification). Modification: Any Junior (age sixteen (16) and younger), who elect with his/her parent or coach (with written power of attorney) to participate in Senior Competition (age seventeen (17) and above) is subject to the Senior s rules and must sign an additional waiver and release at the match prior to his/her senior competition match. Senior competitors will be matched by Rank and Weight according to IJF weight categories, or modified to Light, Medium, and Heavy- Weight categories in the case that divisions have too few competitors to populate the division(s). In these cases, the Tournament Director(s), in conjunction with the Competitor and/or Coach/Parent Team shall determine the competitive division. No arm bars for novice categories (all juniors and below the rank of sankyu). Notes: There will be an allowable ten (10) pound maximum or ten percent (10%) weight difference for juniors or fifteen (15) pounds or fifteen percent (15%) difference for seniors. The Tournament Director, Competitor, and Coach/Parent Team must agree on all exceptions. Elimination or pool systems are subject to change on the day of the tournament depending upon the number of competitors registering for the competition. Contestants may compete in as many divisions as they are qualified to compete in, as long as they properly register and remit the appropriate non- refundable fee(s). Competitors, coaches, and parents are very strongly encouraged to be present for the Referee Meeting & Rules Clinic on the mat at 9:00 on Saturday, February 23, 2013. All are humbly encouraged to participate in our PATRIOTIC TRIBUTE & CEREMONY OF THE ASHES. Please submit the name(s) of your Patriot along with a tax- deductible contribution to help MOJJJO help to continue to assist our Veterans, Active Duty Service Members, Wounded Warriors, Families, and American Amateur Athletes. Contact Sergeant Major E. L. Beshimentob Mayfield at the above addresses and numbers for more information and assistance. All competitors must have a white judo gi, a white obi, and a blue obi as minimum requirements for competition. In lieu of that, the competitor may have a white gi, blue gi, and a white obi. A limited amount of new and used gis and obis will be available for sale on a First come - first served! basis. CUSTOM IMPRINTED tee shirts will also be available on site. Elimination: Double elimination or modified pool system. Match Times: Three (3) minutes for Juniors and Masters with one (1) minute for Golden Score and five (5) minutes for Seniors with two (2) minutes for Golden Score. Awards: There will be medals for First (5 points), Second (3 points) and Third Place (1 point) winners. There will be a Junior and Senior Team Award based upon the above point system. Location: Jacksonville Commons Recreation Center, 100 Recreation Loop, Jacksonville, North Carolina 28541. Head Referee: Mr. Russ Scherer Examiners: Dr. Gary Berliner & Mr. Karl Tamai MOJJJO thanks each of you in advance for coming or at least passing the word. MOJJJO also thanks those of you who serve or served in our military services, or lost loved ones in our Armed Forces, their families, and those who provide the support services to our Fighting Forces. Our thoughts and Prayers are with you always. May GOD (or your Higher Power) watch over you and those whom you care for and about. Best of luck and, Gambate Kudasai! D. M. Maisha & Sergeant Major E. L. Beshimentob Major Mayfield Sponsored by: MOJJJO: (United States Military Outreach Judo & Jiu Jitsu Organization (MOJJJO), Inc.,is a Non- Governmental Organization (NGO) 501. C. (3) non- profit corporation in North Carolina that is registered with the North Carolina Secretary of State (NCSOS) and the Internal Revenue Service (IRS).

2013 th Sergeant Major Mayfield s 8 Open Judo Championships & 4th National Referee and Coach Examination and Certification Entry Form (Please Print Clearly) Junior/Senior/Masters or Coach (circle one) Payment type: Cash/Check #: made out to MOJJJO Amount: $.00 Male/Female Name Last First Middle Address: Street City State Zip Code Phone ( ) Website: www @.com Email: @.com Date of Birth Age Judo Rank Belt Color USJA/USJF/USJI (USA JUDO) # Expiration Weight Dojo/Club: Phone ( ) Instructor Contact and location Information Website: www. @.com and Email: @.com DIVISION(S) YOU WILL COMPETE IN (Senior Weights are in kilograms as per the IJF Rules) Junior Boy/Girl: Age Weight (Light/Medium/Heavy or Regular Weight Divisions) Masters Men/Women: Age Weight (Light/Medium/Heavy or Regular Weight Divisions) Senior Divisions will be contested according to IJF weight categories as follows: Senior Female: 44kg 48kg 52kg 57kg 63kg 70kg +78kg Open Senior Male: 60kg 66kg 73kg 81kg 90kg - 100kg +100kg Open NOTE: The Tournament Director reserves the Right to alter or change any division to establish a more equitable competitive division. All changes will be a collaborative with coach (with appropriate written power of attorney) and/or parent, or the actual competitor prior to the actual change. No arm bars for novice categories (all juniors and below the rank of sankyu).

WARNING! WAIVER AND RELEASE OF LIABILITY AND AGREEMENT TO PARTICIPATE In consideration of being permitted to participate in any way, including travel to and from, in any Judo tournament, practice, clinic, and related events and activities ("Activity") of the United States Judo Federation, Inc., USA Judo, United States Judo, Inc., United States Judo Association, Inc., City of Jacksonville Parks & Recreation Department, and MOJJJO: (United States Military Outreach Judo & Jiu Jitsu Organization (MOJJJO), Inc., Dba, Mayfield s Martial Arts Academy, aka, THE ACADEMY), I agree: 1. I understand the nature of Judo activities and believe I am qualified to participate in such Activity. I also understand the rules governing the sport of Judo. 2. I further acknowledge that prior to participating, I will inspect the mats, equipment, facilities, competition pools or divisions, and the elimination or scoring system to be used, and if I believe anything is unsafe or beyond my capability, I will immediately advise my coach, supervisor, and/or a tournament official of such conditions and refuse to participate. 3. I acknowledge and fully understand that I will be engaging in a contact sport that might result in serious injury, illness or disease, including permanent disability or death, and severe social and economic losses due not only to my own actions, inactions or negligence, but also to the actions, inactions, or negligence of others, the rules of the sport of Judo, or conditions of the premises or of any equipment used. Further, I acknowledge that there may be other risks not known to me or not reasonably foreseeable at this time. 4. Knowing the risks involved in the sport of Judo, I assume all such risks and accept personal responsibility for the damages following such injury, TBI (Traumatic Brain Injury), illness, disease, permanent disability, or death. 5. I hereby release, waive, discharge and covenant not to sue the United States Judo Federation, Inc., USA Judo, United States Judo, Inc., United States Judo Association, Inc., City of Jacksonville Parks & Recreation Department, and MOJJJO: (United States Military Outreach Judo & Jiu Jitsu Organization (MOJJJO), Inc., Dba, Mayfield s Martial Arts Academy, aka, THE ACADEMY), together with their affiliated clubs, their respective administrators, directors, officers, agents, coaches, and other employees or volunteers of the organization, event officials, medical personnel, other participants, their parents, legal guardians, supervisors and coaches, sponsoring agencies, sponsors, advertisers, and if applicable, owners, lessors, and lessees of premises used in conducting the event, all of whom are hereinafter referred to as "Releasees", from any and all litigation expenses, attorney fees, loss, liability, damage or costs on account of injury, TBI (Traumatic Brain Injury), illness, disease, including permanent disability and death or damage to property, caused or alleged to be caused in whole or in part by the negligent acts or omissions of the Releasees or otherwise to the fullest extent permitted by law. I READ THE ABOVE WARNING, WAIVER, AND RELEASE, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND KNOWING THIS, SIGN IT VOLUNTARILY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE. I AGREE TO PARTICIPATE KNOWING THE RISKS AND CONDITIONS INVOLVED AND DO SO ENTIRELY OF MY OWN FREE WILL. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENT/LEGAL GUARDIAN AS EVIDENCED BY THEIR SIGNATURE BELOW. I INTEND THIS TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THAT THE BALANCE, NOTWITHSTANDING SHALL CONTINUE IN FULL FORCE AND EFFECT. Participant Participant s Signature Date FOR PARENTS/LEGAL GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION) This is to certify that I, as parent/legal guardian with legal responsibility for this participant, do consent and agree to his/her release, as provided above, of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless 'the Releasees from any and all liabilities incident to my minor child's involvement or participation including litigation expenses, attorney fees, loss, liability, damage or costs which may incur as the result of the minor child's participation in these programs as provided above, even if arising from their negligence, to the fullest extent permitted by law. I have instructed the minor participant as to the above warnings and conditions and their ramifications. Parent/Legal Guardian Parent/Legal Guardian's Signature Date Form 506 V6.0.0, 09081 8