CHECK IF NO ID (ADMIN ONLY)

TRADING CARD GAME Registration Form

Middle
First Name J o r d a n Name(s) Aldair
Last Name(s) E s c a l a n t e A g u i l a r
CARD GAME ID 0 4 1 1 3 0 9 2 9 4 Date of Birth M
1 M
0 / D D
0 3 / Y1 9Y 9Y 5Y Check here if you
wish to receive
information from
Country of
Event Name Yu-gi-oh! Peru National Championship 2023 Residence Perú KONAMI about
future prizing,
events, and
E-Mail j o r . e s c a l a n t e . 2 6 @ g m a i l promotions

I am voluntarily attending this TRADING CARD GAME tournament and assume all risks that it may involve. I understand that KONAMI, the tournament Please check if this is your first:
organizer, and their agents assume no responsibility to supervise or provide care for participants. By attending this tournament, I agree to the use of my Yu-Gi-Oh!
photographic likeness, name, information and Deck list, in print, photo, livestream, and digital media as part of event coverage. I understand I am not entitled to Regional Qualifier Championship Series
compensation for this usage, and I agree that this information and images may be used without further notice. I represent and warrant that I am of the age of (YCS)
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

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

Date M
2 M
7 / D D
0 5 / Y2 Y0 Y
2 3Y

CHECK IF NO ID (ADMIN ONLY)

TRADING CARD GAME Registration Form
Middle
First Name J o r d a n Name(s) Aldair
Last Name(s) E s c a l a n t e A g u i l a r
CARD GAME ID 0 4 0 1 0 6 5 8 4 3 Date of Birth M
1 M
0 / D D
0 3 / Y1 9Y 9Y 5Y Check here if you
wish to receive
information from
Country of
Event Name Yu-gi-oh! Peru National Championship 2023 Residence Perú KONAMI about
future prizing,
events, and
E-Mail j o r . e s c a l a n t e . 2 6 @ g m a i l promotions

I am voluntarily attending this TRADING CARD GAME tournament and assume all risks that it may involve. I understand that KONAMI, the tournament Please check if this is your first:
organizer, and their agents assume no responsibility to supervise or provide care for participants. By attending this tournament, I agree to the use of my Yu-Gi-Oh!
photographic likeness, name, information and Deck list, in print, photo, livestream, and digital media as part of event coverage. I understand I am not entitled to Regional Qualifier Championship Series
compensation for this usage, and I agree that this information and images may be used without further notice. I represent and warrant that I am of the age of (YCS)
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

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

Date M
2 M
7 / D D
0 5 / Y2 Y0 2Y 3Y

CHECK IF NO ID (ADMIN ONLY)

TRADING CARD GAME Registration Form
Middle
First Name
Name(s)

Last Name(s)

CARD GAME ID Date of Birth M M / D D / Y Y Y Y Check here if you

wish to receive
information from
Country of
Event Name KONAMI about
Residence future prizing,
events, and
E-Mail promotions

I am voluntarily attending this TRADING CARD GAME tournament and assume all risks that it may involve. I understand that KONAMI, the tournament Please check if this is your first:
organizer, and their agents assume no responsibility to supervise or provide care for participants. By attending this tournament, I agree to the use of my Yu-Gi-Oh!
photographic likeness, name, information and Deck list, in print, photo, livestream, and digital media as part of event coverage. I understand I am not entitled to Regional Qualifier Championship Series
compensation for this usage, and I agree that this information and images may be used without further notice. I represent and warrant that I am of the age of (YCS)
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

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

Date M M / D D / Y Y Y Y