Waiver

Please complete the form below

Parent's Name

First Name

Last Name

Email

Child's Name

First Name

Last Name

Date of Birth

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I have no medical history to be aware of

Waiver Declaration

I, the guardian/parent acting for the junior student named on this form waive all claims against any and all persons associated with any of the participating schools and students. I understand that the junior student named on this form is participating in a sport that has body contact. I assume all responsibility for all of his / her actions during and connected to training whilst at Lotus Martial Arts. I understand the risk of training in this form of martial arts and on behalf of my child, hereby release the club organisers and all of its employees and associates from any type of injury, loss or death sustained while attending class. I also state that my charge is in good physical condition and know of no reason why he/she cannot participate in this martial arts training. This student named on this form has current accident and personal liability insurance. In case of emergency, I hereby authorise any licensed medical personnel or trained first aider to perform any accepted medical procedure deemed necessary for my charge and I agree to bear the expense of such treatment. I also agree that the junior named on this form my be photographed, filmed and or videotaped and this is used by the club organisers for social media / marketing purposes. By signing this form I am consenting to the use of images / media for promotional materials as well as not taking any photographs or recording any videos due to child safeguarding I have read the rules and release above and agree to all of its terms and conditions