Action Karate Waiver to Participate
We are excited to have your child(ren) join us for our event. Our main goal is to have FUN while continuing to reinforce key character skills such as respect, confidence and control in all our activities.
In order to participate in our events, we ask that you fill out the information below and submit the form.
Sign in to Google to save your progress. Learn more
Email *
Child's or Participant's Name: *
Date of Birth: *
MM
/
DD
/
YYYY
List any medical conditions we need to be aware of:
What is the main reason you are interested in getting your child started in martial arts?
Clear selection
Parent's Name: *
Cell Phone: *
Release- Member gives permission for images of student, captured during regular and special activities through video, photo and digital to be used solely for the purposes of promotional material and publications, and waive any rights of compensation or Ownership thereto. Member represents being physically fit to take the prescribed program. All use of the facilities shall be under taken at the sole risk of the member. Action Karate shall not be liable to the member for claims, demands, injuries, loss of property or acts of negligence. In consideration for being allowed to participate in Action Karate, the participant and their guardians hereby release, waive, and covenant not to sue Action Karate for any injuries which are sustained while on the premises. *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms