Waiver | Phoenix Martial Arts

Phoenix Martial Arts Waiver and Liability Form

First name

Last name

Date of Birth

Do you have a doctor’s permit to participate in intense physical activities?

Yes

Please specify anything we should know about

Initials

I declare that the info I’ve provided is accurate & complete

I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program. By signing this waiver, I release Phoenix Martial Arts from any and all liability for injuries or damages incurred during my participation in their programs and activities.

Thanks for submitting!

Phoenix Martial Arts Waiver and Liability Form

7951 36th Avenue, Kenosha WI

Phoenixmartialartskenosha@gmail.com

(262) 629.6313