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Conifer Martial Arts and Fitness Child Safety Waiver

HEALTH STATUS: I CERTIFY THAT MY CHILD IS IN GOOD HEALTH AND KNOW OF NO IMPAIRMENT TO THEIR HEATH OR PHYSICAL BEING THAT COULD PREVENT THEM FROM PARTICIPATION IN THE MARTIAL ARTS OR FITNESS PROGRAMS OFFERED BY CONIFER MARTIAL ARTS AND FITNESS.

I ALSO FULLY UNDERSTAND THAT INHERENT RISK EXIST WHEN PARTICIPATING IN MARTIAL ARTS ACTIVITIES AND FITNESS PROGRAMS. I FURTHER AGREE TO ASSUME THE RISK OF ANY ADVERSE EFFECT, INJURY OR OTHER DUE TO TRAINING IN THIS SCHOOLS MARTIAL ARTS OR FITNESS CLASSES.

LEGAL WAIVER: IN CONSIDERATION OF THE PRIVILEGE OF PARTICIPATION IN THE ACTIVITIES OF THIS SCHOOLS
MARTIAL ARTS/FITNESS PROGRAM, I HEREBY WAVE ANY CLAIMS RELATED TO INJURIES DUE TO ACTS OF
NEGLIGENCE. I ALSO HEREBY AGREE NOT TO ASSERT ANY SUCH CLAIM AGAINST THIS SCHOOL, THE OWNER, OR
ANY INSTRUCTORS OR PERSON INVOLVED WITH THIS SCHOOL OR ANYONE CONNECTED WITH CONIFER MARTIAL ARTS AND FITNESS.

STUDENT'S NAME:

STUDENT'S BIRTHDAY:

PARENT OR LEGAL GUARDIAN NAME:

HOME ADDRESS:

Please provide up to two point of contacts in case of an emergency.

EMERGENCY CONTACT NAME:

EMERGENCY CONTACT NUMBER:

SECOND EMERGENCY CONTACT NAME:

SECOND EMERGENCY CONTACT NUMBER:

Leave this empty:

Your legal name

Your email address