Saturday November 8, 2003

8AM registration and check in

9AM Open saber

10:30 AM Women’s foil

11 AM Novice foil (unrated, less than 1 year cumulative)

1 PM Open foil

3 PM Open epee

(Registration Closes 15min before event starts.)

General information:

Name:

____________________________________

Address:

____________________________________

____________________________________

____________________________________

Phone:

____________________________________

Email:

____________________________________

Club affiliation:

____________________________________

Division:

____________________________________

USFA Membership#:

____________________________________

New member? Make check out to USFA for $40, and complete the USFA Membership Application form provided on location.

____ New or ______ renewal member.

USFA Rating/year:

Foil: ____________, Epee: ____________, Saber: ____________

Events and fees:

Events:

Fees:

First weapon $20, each additional weapon $5. Fencers may enter both open, women's foil for $20. Fencers ranked "C" and above fence that weapon free.

Please make checks out to University of Mississippi Fencing Club.

Waivers and Signatures:

This form must be signed to complete registration.

I hereby waive and release all rights and claims for damages I may have against the University of Mississippi Fencing Club, The Oxford Fencers, the University of Mississippi, The Oxford Park Commission, the officials, managers, sponsors, and other participants from any and all liabilities arising from illness, losses, injuries or damages I may suffer as a result of my participation in this fencing tournament. I attest and verify that I am physically fit and have sufficiently trained for this competition. I further waive all rights to any photographs, videotapes, recordings or any other recording of this event for any purpose.

Signature (if under 18, parent or guardian):

__________________________________________________________

Date ____________

Consent for Medical Treatment: (must be signed to complete registration)

I understand and appreciate that participation in the sport of fencing carries a risk to me of serious injury, including permanent paralysis or death. I give my consent to representatives of the University of Mississippi Fencing Club, or the Oxford Fencers, to obtain medical care from physicians, clinics or hospitals for any illness or injury that could arise during this fencing tournament.

Name of Person to contact in an emergency:

______________________________________________________

Phone _____________