Relentless Detroit 2018 Registration

 

Name *
Name
Date of Birth *
Date of Birth
Address *
Address
Phone *
Phone
Choose 1
Choose 1
Choose 1 Raw - with wraps Elite Raw - naked knee/sleeves
Choose the event you'd like to do most
Choose the second event you'd like to do most
Choose 1. Males choose "Male - N/A"
Choose 1. Females select "Female - N/A"
Choose 1
Choose one
Signature *
Signature
*In consideration of the acceptance of this entry thereby for myself, my heirs, executors, and administrators waive and release any and all claims and damages I may have against the UPA, Jeremy Thomas, Harlan Brandenburg, Detroit Barbell, the Kirby Church & their representatives, successors, and assigns for any and all injuries or bodily harm that I may suffer while competing in Relentless Detroit 2018. I attest and verify that I have full knowledge of the risks involved with my participation in this event and that, to the best of my knowledge, I am physically fit and able to participate in this event. I understand that submission of this form doesn't secure my entry. Entry is secured by signing the commitment form and setting up a fundraising page.