Registration Form

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By attending this Trading Card Game tournament, I understand and agree that by my signature below, I agree to the use of my photographic likeness, name,.
CHECK IF NO ID (ADMIN ONLY)

Trading Card Game Registration Form Middle Name(s)

First Name Last Name(s) COSSY ID

Date of Birth

Event Name

Country of Residence

M M

/

D D

/

Y Y Y Y

E-Mail By attending this Trading Card Game tournament, I understand and agree that by my signature below, I agree to the use of my photographic likeness, name, information, Deck list, which may be included in print, photo, and digital media as part of event coverage. I understand I am not entitled to compensation for this usage, and I agree that this information or images may be used without prior notification. I represent and warrant that I am of the age of majority in my state or province of residence (19 or older in NE and AL, and 18 or older in all other U.S. states) (or, if not, that a parent or legal guardian will sign on my behalf). Signature

Date

M M

Self or Parent/Legal Guardian in case of under age of majority

CHECK IF NO ID (ADMIN ONLY)

/

Check here if you wish to receive information from Konami about future prizing, events, and promotions

Please check if this is your first: Regional Qualifier

D D

/

Yu-Gi-Oh! Championship Series (YCS)

Y Y Y Y

Trading Card Game Registration Form Middle Name(s)

First Name Last Name(s) COSSY ID

Date of Birth

Event Name

Country of Residence

M M

/

D D

/

Y Y Y Y

E-Mail By attending this Trading Card Game tournament, I understand and agree that by my signature below, I agree to the use of my photographic likeness, name, information, Deck list, which may be included in print, photo, and digital media as part of event coverage. I understand I am not entitled to compensation for this usage, and I agree that this information or images may be used without prior notification. I represent and warrant that I am of the age of majority in my state or province of residence (19 or older in NE and AL, and 18 or older in all other U.S. states) (or, if not, that a parent or legal guardian will sign on my behalf). Signature

Date

M M

Self or Parent/Legal Guardian in case of under age of majority

CHECK IF NO ID (ADMIN ONLY)

/

Check here if you wish to receive information from Konami about future prizing, events, and promotions

Please check if this is your first: Regional Qualifier

D D

/

Yu-Gi-Oh! Championship Series (YCS)

Y Y Y Y

Trading Card Game Registration Form Middle Name(s)

First Name Last Name(s) COSSY ID

Date of Birth

Event Name

Country of Residence

M M

/

D D

/

Y Y Y Y

E-Mail By attending this Trading Card Game tournament, I understand and agree that by my signature below, I agree to the use of my photographic likeness, name, information, Deck list, which may be included in print, photo, and digital media as part of event coverage. I understand I am not entitled to compensation for this usage, and I agree that this information or images may be used without prior notification. I represent and warrant that I am of the age of majority in my state or province of residence (19 or older in NE and AL, and 18 or older in all other U.S. states) (or, if not, that a parent or legal guardian will sign on my behalf). Signature

Date

Self or Parent/Legal Guardian in case of under age of majority

M M

/

Check here if you wish to receive information from Konami about future prizing, events, and promotions

Please check if this is your first: Regional Qualifier

D D

/

Yu-Gi-Oh! Championship Series (YCS)

Y Y Y Y