disclaimerform

Middleton Martial Arts Academy - Training Disclaimer Form

Student's Name

Address

Address Line 2

Date of Birth

Age

Occupation

Home Tel No

Mobile Tel No

If under 18, Parent / Guardian contact details

Name

Relationship to Student

Home Tel No

Mobile Tel No

Previous Martial Arts Experience

Please provide details

Disclaimer

It is understood and agreed that the club and instructors/helpers, shall not be liable for any damages arising from personal injuries sustained by the student named above in, on or about the premises resulting from or arising out of the use or intended use of the facilities and equipment and instruction of the club. It is hereby warranted that the student has no infirmity or disability which will prevent or impede him/her from participating in the activities and functions of the club or the class or the functions that they are participating in. I also understand and appreciate that I am learning a dangerous martial art and any injuries sustained during training at Middleton Thai Boxing Club and Middleton Brazilian Jiu Jitsu, I do at my own risk and will not hold any parties responsible whatsoever. I take full responsibility for my own actions. Persons under the age of 18 are not permitted to sign on their own behalf and therefore a parent/guardian must read the disclaimer and sign on their behalf and take full responsibility to understand and agree with the above statements, giving them signed permission on their behalf to train after reading this disclaimer. I understand the details on this form are true and correct. The above is also applicable to all other activities at Middleton Martial Arts.

I have read, understood, and agree to the disclaimer above.

Signature Details

Print Name

Signature of Student (18 or over)

For online submission, typed full name can be used as an electronic signature.

Signature of Parent / Guardian

I grant full rights to use the images resulting from photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes to help achieve the group's aims. This may include, but is not limited to, the right to use them in printed and online publicity, social media, press releases and funding applications.

Date

Address:
Back Spring Gardens
Cheapside
Middleton
Manchester
M24 6DB

Tel: 07868107860
Tel 2:
Email: [email protected]

Contact Form

Tel Greg on 07868107860

Contact Details

Contact Us Today