Guest Registration - Stick Warrior Martial Arts

**Complete one form for each student.**
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This form is for you Complimentary Class(es). * Complete the Form and submit. A confirmation email will be sent to the email you provide and a representitive will contact you to schedule a date for your class.

Student Information

Student Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Date of Birth

Student Email

Phone

Parent/Guardian Information (N/A if student is over 18)

Is the student a minor?

Student is 18 or older

Emergency Contact

Name

First

Last

Phone

Emergency Contact Email

LIABILITY/ASSUMPTION Parent/Guardian TREATMENT.

Medical Concerns

WAIVER AND RELEASE OF LIABILITY/ASSUMPTION OF RISK:

The Member understands and agrees that the use of Stick Warrior Martial Arts’ facilities and the Member’s presence at Stick Warrior Martial Arts’ facility are at the sole risk of the Member. The Member understands and agrees that martial arts involves skills and training which include violent and sudden movements and that in connection with the training and instruction there will be physical contact between instructors and Members and between and among Members and that such contact may result in personal injury to the Member; despite precautions being taken to prevent such injuries. Members hereby consent to engage in such contact as may be necessary or required by Member’s participation in the training programs and/or classes and assume all risks associated with such training and participation. Member, on behalf of him/herself and anyone claiming by or through the Member, hereby holds harmless, releases, and forever discharges Stick Warrior Martial Arts, its instructors, agents, employees, operators, landlord, and authorized representatives from any liability, claim, loss of property, damage, personal injury, or expense incurred by the Member and arising from the Member’s execution of this agreement, payment processing, participation in any program offered by Stick Warrior Martial Arts, including, but not limited to, any injury or damage caused by the negligence or willful misconduct of Stick Warrior Martial Arts, its instructors, members, agents, employees, operators, and authorized representatives.

ACCEPTANCE OF MEMBER.

By signing this agreement, Member agrees to fully and completely comply with all terms and conditions hereof and Stick Warrior Martial Arts’ rules and regulations. Failure to comply with Stick Warrior Martial Arts’ rules and regulations is grounds for immediate suspension or termination of the Member. Suspension or termination shall not entitle the Member to a refund or credit for tuition already paid or cancel any unpaid balance due. The failure or inability of the Member to use the facilities, classes, or services of Stick Warrior Martial Arts for any reason, except as otherwise provided herein, does not relieve or suspend the Member’s obligation to make payments required under this agreement on a timely basis, nor entitle the Member to a refund or credit. Unless otherwise indicated on the front page of this agreement, upon the expiration date of this agreement, the agreement will automatically renew as an agreement on a month-to-month basis, and all provisions of this agreement shall remain in full force. Members understand and agrees that full payment of tuition is not a guarantee or promise of advancement. Stick Warrior Martial Arts and those acting under its authority reserve the right to use written statements, photographs, videotapes, artwork or other likenesses of the Member for marketing, trade, publishing, or any other lawful government purpose.

STUDENT FITNESS.

By signing this agreement, Member represents, warrants, and insures that he/she has had an opportunity to observe the programs offered by Stick Warrior Martial Arts and that, in lieu of a medical certificate signed by a medical doctor, he/she has no knowledge of any physical or mental impairment that would be affected by the named student’s participation in programs offered by Stick Warrior Martial Arts.

EMERGENCY MEDICAL TREATMENT.

I hereby authorize Stick Warrior Martial Arts, to act for me in the event of any emergency requiring immediate medical attention. All medical expenses incurred will be the responsibility of the Member or Member’s family.

**If you do not receive a confirmation email, check your junk mail**