Having received a commission from the officers and athletes participating in the CHUNCHEON KOREA OPEN International Taekwondo Championships 2017, the above signer hereby apply for personal accident insurance through Organizing Committee. The personal accident insurance covers only the injuries that happen during the Championships period(July 2 ~ July 7, 2017). Individuals including the officers and athletes participating in the aforementioned championships hereby indemnify and hold harmless the Organizing Committee of the Championships, the Korea Taekwondo Association and the World Taekwondo Federation from and against any personal damage and property damage caused by or resulting from all accidents caused in connection with the Championships and such personal or property damages shall be compensated for by the insurance the above signer has taken out privately.
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Do you have any health problems? Yes ( ), No (
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If the answer is Yes, Please elaborate below.
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Do you require any particular medication? Yes ( ),
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No ( )
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Each of the officers and athletes participating in the Championships fully understand that Taekwondo is a sports allowing physical contacts between competitors and that he or she shall observe the rules and regulations of the World Taekwondo Federation and the operation regulations of the CHUNCHEON KOREA OPEN International Taekwondo Championships and that he or she shall not engage in any activities causing any malicious effect to the Organizing Committee during the championship period, and shall not demand return of the registration form or fee. Therefore, I, the undersigned, hereby sign and submit this report with respect to the foregoing provisions.
Name of athlete:
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Signature
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Date and time: 2017. . .
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Name of guardian:
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Signature
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Date and time: 2017. . .
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Athlete or Guardian
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Representative of an association or a group
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※Individual Participant : signature of the athlete or a guardian
※Participant with an association or a group : signature or seal of a representative
