• PALMETTO OPEN REGISTRATION FORM

    JULY 15, 2023 / LYCAN MMA / 1916 TAYLOR ST / COLUMBIA SC
  • Release agreement: For and in consideration of my participation in the foregoing event sanctioned by South Eastern Sambo Association and North American Combat Ju Jitsu International Federation, I intend to be legally bound, hereby myself, my heirs, and administrators, waive and release any and all rights to damage or claims against said organization(s), their governing bodies, officials, and members for injuries or rights to damages suffered by me directly or indirectly as a result of attending, participating in, practicing for, traveling to or from such event, or against South Eastern Sambo Association, North American Combat Ju Jitsu International Federation, vendors, staff, owners, or volunteers of event facility, USA Sambo Inc or any of its representatives the city of Greensboro, facility, or any employee thereof, or any of the event's sponsors or endorsing bodies, staff members, jor instructors. I further certify that I am in prooer health and physical condition to participate in such activities.

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  • (If under the age of 18, parental signature required)*

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        ONE DIVISION (SPORT OR COMBAT)ONE DIVISION ONLY
        $50.00
          
        SECOND DIVISION (SPORT OR COMBAT)SECOND DIVISION (OPTIONAL)
        $15.00
          
        Total
        $0.00

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