Conifer Martial Arts and Fitness Waiver


Student Information

Name:
Address:

City:

Zip Code:

Phone #:

Email:


Consultation Questions (must be complete before training)

How did you hear about Conifer Martial Arts and Fitness?

Additional Notes:

Have you ever trained before?

Additional Notes:

Are you currently employed?

 

Does our training schedule fit with your work hours?


Would you be able to train at least 2 times a week?

What is your Fitness/Training goal?

 

Would you be able to make a decision to train today?

 

HEALTH STATUS: I CERTIFY THAT I AM IN GOOD HEALTH AND KNOW OF NO IMPAIRMENT TO MY HEATH OR PHYSICAL BEING THAT COULD PREVENT ME FROM PARTICIPATION IN THIS SCHOOLS MARTIAL ARTS OR FITNESS PROGRAMS. 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 OF MY HEALTH 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 CLAIMES 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 SAID ORGANIZATION.

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Signature Certificate
Document name: Conifer Martial Arts and Fitness Waiver
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May 15, 2022 10:41 am MDTConifer Martial Arts and Fitness Waiver Uploaded by Philip Miller - phil@conifermartialarts.com IP 72.19.170.115
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