KMC Registration Form
Last Registration Day - October 5th, 2026
Attendee Information
Please fill name and contact information of attendees.
Your Name
Mr.
Mrs.
Miss.
Prefix
First Name
Last Name
Email Address
example@example.com
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Will you have a guest with you?
Yes
No
Guest Name
Mr.
Mrs.
Miss.
Prefix
First Name
Last Name
Would you like to be updated about the upcoming events?
Yes
No
Competitions to participate in the following : (Maximum of 2 choices)
Classic European Swedish Massage (In this category there are no tools, no stools, no stretching, no forearms, no kneeling. Techniques should be complete, clean and flow seamlessly from one technique to another.)
Asian massage (Thai massage, Shiatsu, Tui Na, Ayurveda etc.)
Wellness massage (Hot Stone, Aromatherapy, spa massage, lymph drainage, holistic massage etc)
Western Free style massage (Combination of different types of western massage methods, self-treatment, mobilization, cupping, massage with tools, bodywork etc.)
Eastern Free style massage ( Combination of different types of Asian massage methods (Shiatsu, Acupressure, Thai massage, cupping, massage with tools, etc.)
Sports massage (Deep-Tissue massage, MFR, MET, neuromuscular techniques, stretching, etc.)
Chair massage (both Western and Eastern inspired massage)
Facial massage (Japanese face lifting, Gua Sha, Classical facial spa treatment etc.)
Facial (without chemical peels, extractions, etc.)
Clinical massage ( 30 minutes + interviews. You must show that you can assess and treat a problem area, demonstrate/explain how and why the treatment type was a good choice, exhibit efficacy)
Barefoot massage
Body shaping/contouring massage
State liscene
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Head shot
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Liability Insurance*By submitting this application, I understand that my participation in the competition REQUIRES that I have liability insurance active during the dates of the competition. I UNDERSTAND THAT I WILL NOT BE PERMITTED TO PARTICIPATE IF THIS DOCUMENT IS NOT PROVIDED.
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SignatureLiability*I understand that the Kentucky Massage Championship will not be held responsible or liable for any items that are lost, stolen, or damaged during the event. I understand that I am voluntarily participating in the Kentucky Massage Championship and I am participating in the Championship at my own risk. I agree that I will be fully responsible financially for any injury or damages, including attorney's fees, hospital and medical care, that that may acquire during the event due to negligence or irresponsibility. In the event that I should require medical care treatment, I agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance, and massage therapy liability insurance.
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Entry Fee
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Participant Entry Fee
Licensed Therapist
$
100.00
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Item subtotal:
$
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Student Entry fee
current student
$
50.00
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Credit Card
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