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Application for Admission & Release of Liability

Personal Information

General Health Information (Provide as much as you can).

Training Objectives - For you or your children. (Check the top three in each categories)


Release of Liability

This is a release and is intended to discharge in advance AMERICAN MARTIAL ARTS ACADEMY, its instructors, employees and staff from any and all liability arising out of my participation in said activity. I hereby waive, release and discharge any and all claims for damages, personal injury, death, or property damage which I may have or which may hereafter occur to me, as a result of participation in said activity. I understand that this activity may involve elements of risk and danger of accidents and knowing those potential risks, I hereby assume those risk. I agree to indemnify and hold to the agents free and harmless from any loss, liability, damage, cost or expense which they may incur as a result of my death or any injury or property damage that I sustain while participation in program. In the event myself or an emergency contact cannot be reached in an emergency, I hereby give my permission to the physician selected my AMERICAN MARTIAL ARTS ACADEMY staff to hospitalize, secure proper treatment for and to order injection, anesthesia, or surgery for my child (or self) as named above.

Thanks for registering to our event. See you there!

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