Student Registration And Liability/waiver Form
Download a blank fillable Student Registration And Liability/waiver Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Student Registration And Liability/waiver Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Student registration and Liability/Waiver Form
SOARING EAGLE KUNG FU, INC.
Assumption of Risk, Waiver, and Release from Liability
Student Name
___
Student ID#
Today’s date:
Age
Gender
Address
________________________________________________________________
Street
City
State
ZIP Code
Home Phone:
Email
Cell Phone:
Other Phone:
Parent or legal guardian (for children under the age of 18)
Name
Relationship
Address
________
Phone
If different from above
Emergency Contact Information:
Name
Relationship
Address
________
Phone: Home
Cell
________________
Health Insurance Provider:
Company Name
Policy Number
By signing below, I
(PRINT NAME) hereby give my consent and permission to
SOARING EAGLE KUNG FU, INC. and to its employees and authorized agents to interview, take
photographs, motion pictures, videotape and/or sound recordings of me or of ___________________ for whom
I am legally responsible. In addition, I have read, understood and signed the liability/waiver form on the back.
Student’s SIGNATURE: __________________________________
Date: ______________
Parent’s or Legal Guardian’s SIGNATURE: __________________________
Date: _______________
--------------------------------------------------------------------------------------------------------------------------------------
This application is processed by Master Kaifei Song
Date: _______________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Life