AMA Taekwondo Birthday Party Permission/Waiver Slip
Welcome to Agbon Martial Arts! Please complete information below (per participant) prior to joining the activity. 

If you have any questions, feel free to contact Agbon Martial Arts at (847) 219-9932 or agbonmartialarts@gmail.com. Located at 1417 Lake Ave. Wilmette, IL 60091.

FREE PARKING in front and Additional parking available behind the building (2 spots with the sign of "1417 Lake Ave Customers ONLY"), Metra station FREE PARKING Mondays - Fridays at 3pm onwards and on the Weekends ALL day, Park Ave. ( West of dojang/studio- Parking on Weekends allowed) and by Washington St. (1 block south of Lake Ave.; where Starbucks).
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Email *
Adult Full Name (Parent/Guardian for participants 17yo and younger) *
Participant Full Name
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Participant Date of Birth *
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Birthday Party Celebrant's Name *
Activity Date *
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Activity Start Time *
Time
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Email *
Address *
Phone number *

Waiver and Release of All Claims and Assumption of Risk:  Please read this form carefully and be aware that in signing up and participating in Agbon Martial Arts program, you will expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with this program/activity. I recognize and acknowledge that there are certain risks of physical injury to participants in this program, and I voluntarily agree to assume the full risk of any injuries, damages or loss, regardless of severity that my minor child/ward or I may sustain as a result of participating in any and all activities connected with or associated with this program/activity. I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my child/ward as a result of participating in this program/activity against Agbon Martial Arts, including its officials, agents, volunteers and employees. I do hereby fully release and forever discharge Agbon Martial Arts from any and all claims for injuries, damages or loss that my minor child/ward or I may have or which may accrue to me or my minor child/ward and arising out of, connected with, or in any way associated with this program/activity.

Photo/Video Authorization: I hereby give my consent to Agbon Martial Arts to use photos/video coverage of myself and/or minor child/ward in future Agbon Martial Arts program guides, flyers, videos, websites, etc. I understand that the Agbon Martial Arts staff may take photos/video coverage of its programs and events, and their participants from time to time and that these photos/video coverage remain the property of Agbon Martial Arts.

I have read and fully understand the above important informations about assumption of risk and waiver and release of all claims and Photo/Video authorization. If registering online my on-line signature shall substitute for and have the same legal effect as an original form


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