MARTINEZ ACADEMY OF ARMS

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TWO DAY SEMINAR ON
LA VERDADERA DESTREZA
APPLICATION FORM

Please type or print all information:

Last Name________________________First Name__________________M.I._________

Mailing Address___________________________________________________________

City___________________________________State_____________Zip______________

Phone(____)____________Fax(_____)____________E-mail_______________________

Date of Birth______/______/______ Gender (M/F)_____Years Fencing__________

Pre-registration fee is $150.00 for Saturday & Sunday. Fee for Saturday only is $90.00. Deadline for pre-registration by mail is August 18th, 2000. Registration fee the day of the seminar is $200.00 for Saturday & Sunday. Fee for Saturday only is $125.00.

Please check one: [ ] Saturday & Sunday     [ ] Saturday Only

All participants must read and sign the following:

Waiver of Liability

Upon participating in this seminar/workshop, I agree to abide by the rules and conditions of the event. I understand and appreciate that participation in fencing carries a risk to me of serious injury, including permanent paralysis or death. I knowingly recognize, accept and assume this risk upon participating in this seminar/workshop and release the Martinez Academy of Arms, St. Peters College, and the participants, from any liability.

________________________________________________  ________________________
Fencer's Signature                                Date

Please make checks or money orders payable to Ramón Martínez and mail forms & payment to:

Maestro Ramón Martínez
1417- 37th Street
North Bergen, NJ 07047