Sunday, April 26, 2015
HARPER COLLEGE - WELLNESS & SPORTS CENTER
1200 Algonquin Road, Palatine IL • Roselle & Algonquin Roads
I hereby for myself, my executor(s), my heirs, forever and always agree to save and hold harmless the Illinois Shotokan Booster Club, the llinois
Shotokan Karate Clubs, Harper College, instructors, volunteers, and anyone else for any liability or injury I may sustain by the way of my traveling
to or from, participating in, or other direct or indirect involvement in said karate event I have entered. In addition, I hereby for now and forever
accept any and all responsibilities for any actions in conjunction with said event, and for the traveling to or from or participation in said event.
Finally, I agree to allow without compensation, the unrestricted use of any photographs, films, or video tapes of myself taken during the event
Contact:
Fax: (847) 359-6182 Attn: Judy
Email: judyd@iskc.com
