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Boxer Registration Page

Name*
Email Address*
Age*
DOB*
Employer*
Gun or Hose
Gender*
Weight (lbs)*
Height (inches)*
Sweatshirt Size*



Waist Size (inches)*
At which gym will you train? (required) *
Street Address*
City*
Zip Code*
Primary Phone*
Alt. Phone
My Sponsor is: (contact name, phone number, etc.)

I have a friend/spouse/co-worker/significant other who would like to be volunteer to be a part of Guns N' Hoses Wichita:

Name
Phone
Name
Phone
 

By submitting this form you agree to the following:

In consideration of your accepting this entry, I intend to be legally bound, hereby for myself, my heirs, executors and administrators, waive and release any and all claims for damages I may have against the Wichita Crime Commission, Crime Stoppers of Wichita/Sedgwick County and their boards of directors and employees, agents and assigns for all and any injuries suffered by me at the Guns ‘n Hoses Wichita Boxing Tournament, special appearances, boxing sessions, training or classes.

I currently am not under any medical restrictions or taking any special medications. Also, I am not pursuing any type of workman’s compensation claim at this time.

I grant permission to Guns ‘n Hoses Wichita Boxing Tournament, the Wichita Crime Commission and Crime Stoppers of Wichita/Sedgwick County permission to use my name, photographs, and/or videos for Guns ‘n Hoses Communications and/or advertisements, and I waive any rights to compensation for such use.


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DATE: May 3, 2013 FOR IMMEDIATE RELEASE CONTACT: Gordon Bassham Executive Director Crime Stoppers of Wichita/ Sedgwick County 316-267-1235 ** News Release ** Late on the morning of Th
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