Request edit access
Waiver For Green's Karate
You represent to us that you (the member) have no physical, mental, or emotional illness that could impair training or that could make the training injurious. Every effort will be made on our part to make classes as safe as possible. You further understand that any photos and videos could be used for promotional purposes. You realize that any physical activity has the potential for injury and you forever indemnify any claim or negligent tort damage against us, and/or our principals, officers, instructors, coaches, or teachers resulting from the activity. The member must also sign our Non-Disclosure Agreement prior to starting class. I hereby acknowledge an assumption of risk by accepting and agreeing to allowing myself/my child to participate in karate and/or kickboxing activities.
Sign in to Google to save your progress. Learn more
Email *
Student First Name (please complete one per student): *
Student Last Name: *
Student Last Name: *
Date of Birth *
Parent First Name <if applicable>: *
Parent Last Name: *
Phone Number (111-222-3333):423 637 9914 *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy