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    New MSBJJF Reg Form

    Uploaded by

    Matt WhoDat Ruby
    This registration form is for official competitions hosted by the Mississippi Brazilian Jiu Jitsu Federation. It collects contact and biographical information from registrant Noah Ruby, including his name, address, date of birth, team affiliation, and emergency contact details. The form also allows Ruby to select the divisions and weight classes he wishes to compete in, including the 10-12 year old no-gi division. By signing the form, Ruby acknowledges the risks of competition, agrees to the tournament rules and waives liability for the organizers. He also consents to the commercial use of any photos or footage from the event. Pre-registration costs $60 if completed by Thursday before the event.

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    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd

    New MSBJJF Reg Form

    Uploaded by

    Matt WhoDat Ruby
    32 views1 page
    This registration form is for official competitions hosted by the Mississippi Brazilian Jiu Jitsu Federation. It collects contact and biographical information from registrant Noah Ruby, including his name, address, date of birth, team affiliation, and emergency contact details. The form also allows Ruby to select the divisions and weight classes he wishes to compete in, including the 10-12 year old no-gi division. By signing the form, Ruby acknowledges the risks of competition, agrees to the tournament rules and waives liability for the organizers. He also consents to the commercial use of any photos or footage from the event. Pre-registration costs $60 if completed by Thursday before the event.

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    33977165 New Msbjjf Reg Form

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    © Attribution Non-Commercial (BY-NC)

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    This registration form is for official competitions hosted by the Mississippi Brazilian Jiu Jitsu Federation. It collects contact and biographical information from registrant Noah Ruby, including his name, address, date of birth, team affiliation, and emergency contact details. The form also allows Ruby to select the divisions and weight classes he wishes to compete in, including the 10-12 year old no-gi division. By signing the form, Ruby acknowledges the risks of competition, agrees to the tournament rules and waives liability for the organizers. He also consents to the commercial use of any photos or footage from the event. Pre-registration costs $60 if completed by Thursday before the event.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    32 views1 page

    New MSBJJF Reg Form

    Uploaded by

    Matt WhoDat Ruby
    This registration form is for official competitions hosted by the Mississippi Brazilian Jiu Jitsu Federation. It collects contact and biographical information from registrant Noah Ruby, including his name, address, date of birth, team affiliation, and emergency contact details. The form also allows Ruby to select the divisions and weight classes he wishes to compete in, including the 10-12 year old no-gi division. By signing the form, Ruby acknowledges the risks of competition, agrees to the tournament rules and waives liability for the organizers. He also consents to the commercial use of any photos or footage from the event. Pre-registration costs $60 if completed by Thursday before the event.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 1

    Mississippi Brazilian Jiu Jitsu Federation www.MSBJJF.com – travis@graciesouth.

    com

    Registration Form for the Official MSBJJF Competitions

    Name:_____Noah Ruby____________________________Address:_109 Richland Dr West

    City: ______Mandeville__________ State/Province: _______LA_______________Zip Code:___70448_____________

    Home Phone: _________504 812 3167_____ Date of Birth: __10/03/1997_______ Team Name:_________________

    E-mail: [email protected]_______________________________________ Sex:_______M____________

    BRAZILIAN JIU JITSU DIVISIONS: Mark (X) Absolute( open weight)


    _______________BJJ Weight Classes: White Blue Purple Brown Black

    4-6yrs 7-9 yrs 10- 12yrs 13-15yrs Juvenile

    Adult Master Senior

    NO GI DIVISIONS: Mark (X) Absolute( open weight)


    _______________NO GI Weight Classes: Beginner Intermediate Advance

    4-6yrs 7-9 yrs X 10- 12yrs 13-15yrs Juvenile

    Adult Master Senior

    TOURNAMENT RELEASE AND WAIVER: I understand the rules of the tournament and will abide by them. I understand that I am participating in a
    sport that has body contact and understand that injury can occur with my participation. I assume full responsibility for all of my actions during and
    connected to the above tournament. I understand the risk of competing in this form of Martial Arts competition and hereby release the event organizers
    and all of its employees and associates, tournament sponsors and the event facility, from any type of injury, loss, or death sustained while competing in this
    competition. I also state that I am in good physical condition and know of no reason why I cannot participate in this event. I have current and valid health
    insurance. I understand that The MSBJJF LLC does not offer refunds and divisions or weight classes are subject to change. In case of an emergency, I
    hereby authorize any licensed medical personnel to perform any accepted medical procedure deemed necessary and I agree to bear the expense of any such
    treatment. I also agree that my attendance and/or performance at the tournament will be photographed, filmed, and/or taped and used exclusively by The
    MSBJJF LLC for promotional or commercial purposes and I waive any compensation thereof. I agree to not use ANY footage obtained at the event for
    commercial purposes without expressed, written consent from The MSBJJF LLC.. I have read the rules and release above and agree to all of its terms.
    Signed: _______________________________ Print Name:___Matthew D. Ruby_________ Date:
    _08/02/2010________

    PRICING:
    Brazilian Jiu Jitsu /No Gi
    Pre Registration (till Thursday before the event) $60

    Www.Msbjjf.com

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