4480 Steubenville Pike,
Pittsburgh, PA 15205
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Fulfill a Dream Sign Up

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Which events are you participating in?
Weapons
Kata
Kumite
Breaking

Liability Waiver:

I, being of sound mind, affirm, acknowledge, and recognize the inherent and possible risks of participating in a martial arts tournament. I agree to waive, release, and relinquish the right to bring any claim, action, or any other legal proceeding in any court of any jurisdiction against Mr. John Buckley, his heirs, successors, or assigns. American Streetwise Karate TM, it's members, instructors, agents, servants, employees, owners, and/or any other person or persons acting by, or through, American Streetwise Karate. Kennedy Twp IVFC, it's members, instructors, agents, servants, employees, owners, and/or any other person or persons acting by, or through Kennedy Twp IVFC, for any personal injury whatsoever, regardless of severity, resulting from participation in the Fulfill a Dream Tournament hosted by American Streetwise Karate.

Furthermore, I agree to this release and waiver, binding myself or my child, my heirs, executors, administrators, assigns or successors. By checking "agree" below, I affirm I have read and understand the above agreement, and intend to be legally bound thereby.

I Agree I Disagree

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17 & Younger
If 17 & younger, please enter parent's name:

Once you submit this form, you will receive an email back to confirm. If you do not get an email back, please resubmit. You may pay using Paypal to senseirugh@hotmail.com if you'd like. Thank You!