Text Box:       National Women’s Martial Arts Federation Regional Training October 2-3, 2010   Name________________________________________age_______phone_______________   Address______________________________    City______________ state____   zip _____   Email__________________________________________ Rank/Dan________________   How long have you been studying martial arts?_______ Are you a current NWMAF member?   yes      no Do you have any physical limitations we should know about? (Please explain)________________________________________________________________________________________________________________________________________________________   ______Yes, I would love to participate in the first NWMAF Regional Training Camp on October    2-3, 2010 being held in  Stafford, Virginia. *Please enroll me as a NWMAF member  ($150 for two days/or $85 for one day)   ___Yes, I would love to participate in the first NWMAF Regional Training Camp on October 2-3, 2010 being held in Stafford, Virginia. I am a current NWMAF member. ($110 for two days/ or $65 for one day. AmEx / MC / Visa   card #_____________________________________________exp.date_______________ PLEASE READ THE FOLLOWING AND SIGN. The participant (guardian) agrees to comply with National Women’s Martial Arts Federation and Power Kix Martial Arts training/sparring rules and acknowledges that the martial arts training and seminar participation can be physical, and that participation in such a program and/or event can result in injury to the participant.  The participant (guardian) hereby waives any and all claims for damages or injury against National Women’s Martial Arts Federation, Power Kix Martial Arts, Arlene Limas, Jeanette Kurucz and/or Lauren Wheeler or any individual connected with the organizations, and expressly assumes all risks of whatever nature resulting from said participation.  Additionally, the participant is (the guardian is) fully aware of his or her (participant’s) personal medical conditions and hereby certify that he/she (the participant) is mentally and physically fit to participate in said activity and/or event.   Participants name_____________________________________  Date___________ Participant and or Guardian’s Signature___________________________________     *Membership into the NWMAF will NOT be available with the one day seminar option. Registration FormFor more information, call 540-720-1988fax completed registration to: 540-720-0082