For the 2025 Korean Consul Cup

Parent/Guardian Name:
Child/Participant Name:
Coach/Authorized Representative: Lois Fong / Agassi Cheung
Event: 2025 Korean Consul Cup
Date of Event: October 11, 2025

1. Purpose

This form allows the Parent/Guardian to authorize the Coach/Authorized Representative to sign the official Liability Waiver required by the organizers of the 2025 Korean Consul Cup, after confirming they have read and agreed to its terms.

2. Consent and Authorization

I, the undersigned Parent/Guardian, hereby authorize the Coach/Authorized Representative named above to sign the Liability Waiver on my behalf, for the sole purpose of registering my child in the 2025 Korean Consul Cup.

I acknowledge and agree that by signing this authorization, I am personally bound by the terms of the Liability Waiver as though I had signed it myself.

3. Liability Release

I confirm that:

• I have read the official Liability Waiver (included below).

• I understand and agree to all risks, conditions, and terms.

• I release the Coach/Authorized Representative from any responsibility beyond acting as my signatory.

4. Duration

This authorization applies only to the 2025 Korean Consul Cup on October 11, 2025.

5. Official Liability Waiver (as provided by the Event Organizers)

I, the undersigned, hereby submit my application for registration in this Taekwondo Championship. I voluntarily assume all risks in any way connected with my participation in the said championship and hereby waive all claims howsoever caused, including negligence, against any and all persons and any and all organizations and championship directors connected with the above actions and conduct during and in connection with the said championships. I agree that my performance or attendance at the competition or both may be filmed or otherwise recorded or telecast live, and I consent to the use by the Tournament Officials and/or Directors of the above mentioned Championship, to use my name, likeness, voice, poses, pictures, and/or biographical data concerning me, fully or in any language with or without material throughout the world without limitation, for television radio and/or theatrical motion pictures by any device known or hereafter devised and I waive compensation therefore.

Concussion/Medical Disclosure:
Have you suffered a concussion, head injury, loss of consciousness, or blow to the head followed by dizziness, memory loss, or headache in the past 6 months? If you answered “Yes” to the last question you will need to provide a note from your doctor providing you with medical clearance.

6. Signatures

Parent/Guardian Name (print):