Registration starts: Friday 2pm
                      Camp ends: Sunday at 330pm

Sign-in will continue throughout Friday evening for those arriving late.  Everyone will need to be picked up and signed out by 5pm on Sunday.  The pricing includes room, food and all training.  Please bring a sack lunch for Friday night.

Week-End with Region 6 will be held in Mexico, Missouri on the campus of the Missouri Military Academy.  The Academy offers air-conditioned barracks that have a T.V., game room and accommodations are two (2) per room.  The 288-acre campus offers a field house that has an indoor track and 4 basketball courts. There will be a dining room offering all meals during this course.

Camp Classes
Certified instructors teaching all aspects of Taekwon-Do

Camp Fees
10th Gup thru 3rd Dan: $95.00 
              4th & 5th Dan: $80.00
                      6th Dan & Masters: Guests of Camp
Family Rate: 1st Person: Full Price
Each additional family member: $80.00
Parents, etc... Not participating in the TKD classes: $70.00 per person

We need EVERYONE to fill out a registration form for planning purposes

Campers will supply their own pillow, linens, blanket, etc. for sleeping (twin bed), two campers per room
Don’t forget bathroom items along with towels for showering & food for Friday night

(Checks payable to Region 6-Missouri)

Mail to:  Master Tom Cope    Box 149     Martinsburg, MO         65264

Applications with deposit ($25.00) need to be returned by July 1st, 2009

Deposit is non-refundable.  Remainder may be paid at camp sign-in if not paid in full with registration.                                  
No checks will be cashed until after camp!!!!!!

Registration for Camp
July 31st thru August 2nd, 2009

Name:  _______________________________  Age: _____  Date of Birth:  _________

Address:  ____________________________________  Phone (___) _____________

City:  ________________________________State:  __________ Zip:_____________

Name of TKD School:  _____________________________  Rank:  _______________
 
T-Shirt Size (Adult Sizes)   S______M______L______XL______XXL______      (mark one)

Camp Fees:                            10th Gup thru 3rd Dan: $95.00 
                                                               4th & 5th Dan: $80.00
                                                      6th Dan & Masters: Guests of Camp
Family Rate:                                             1st Person: Full Price
                               Each additional family member: $80.00
Parents, etc. Not participating in the TKD classes: $70.00 per person

Application, Liability & Photograph Release

I hereby make application into “A WEEK-END WITH REGION 6" .  Upon acceptance I agree to obey all rules and regulations handed down by the Camp Director and the Instructors of the camp.  I recognize that there may be a risk involved in Taekwon-Do which requires my adherence to these rules and regulations and to the Camp Directors discipline. 

In consideration of your acceptance of me and /or my child, indemnify, release, forever discharge and agree to hold harmless the Missouri Military Academy, Region 6, Camp Director, any and all Instructors, the USTF, and any parents and guests from any and all liability, claims, or demands for personal injury, sickness, or death, as well as property damage, loss and expenses of any nature whatsoever, including reasonable attorneys fees, which may be incurred by the undersigned and/or child-participant while participating in the camp. 

I clearly understand that the sport and art of Taekwon-Do involves bodily contact.  I am aware of my and my child’s personal medical condition and hereby certify that may and/or my child’s participation is voluntary and that I and/or my child are mentally and physically fit to participate in said event.

I hereby consent to and authorize the taking of photographs or videotape in which I and/or my child mine appear.  I hereby waive for myself and for and on behalf of my child all rights of privacy in and to any said photographs or tapes, including without limitation, any and all claims for libel and or invasion of privacy.  I hereby grant for myself and for and on behalf of my child to Region 6 the irremovable right and permission, in respect to the photographs or videotape that has been taken of me or my child to use, re-use, publish, re-publish, modify and display the same, in whole or in part, individually or in conjunction with other photographs, and in conjunction with any other copyrighted matter, in any and all media now or hereafter known, for illustration, promotion, art, advertising and trade, or any other purpose whatsoever, and to use my name and/or my child’s name in connection therewith if Region 6 or the Camp Director chooses.  
Medical Information

My Health Insurance is through:__________________________________________
Important Medical Info:___________________________________________________
_____________________________________________________________________
Signature:_________________________________Date__________
Parent or Guardian Signature: ____________________________________________

Master Tom Cope
Box 149    
Martinsburg, MO 65264

Directions to Missouri Military Academy

From St. Louis: Take Interstate 70 west to Kingdom City and U.S. Highway 54 (exit 148).  Take Highway 54 east (north) 17 miles and exit on Business 54 at the first Mexico exit.  Travel to the first traffic light and turn right.  Continue through the next 4-way traffic light and follow the signs to MMA (2 blocks past last 4-way traffic light)

From Kansas City:  Take Interstate 70 east to Kingdom City and U.S. Highway 54 (exit 148).  Follow directions above.

From Highway 63:  Take Highway 22 east to Mexico.  Continue through the first set of lights to the next 4-way stop.  Turn right and continue through the next two sets of 4-way stops.  At the third stop, (you will be at an overhead bridge) turn left and continue through the next 4-way stop to the next stop light.  Turn left on Agriculture and follow the signs to MMA.