Self Defense Class Registration
Safety & Self Defense Class - October 27th 1:30-4:00 pm at Bullard FUMC Family Life Center
Please arrive by 1:15 pm in comfortable clothing. Modest exercise attire recommended.
First & Last Name of Participant *
Your answer
Parent Name (if participant is a minor)
Your answer
Email address
Your answer
Home address *
Your answer
Phone *
Your answer
Age (Must be 13 or older. Anyone under 18 must be accompanied by a parent/legal guardian.) *
Your answer
I assert that I am (or the participant named above, if minor, is) healthy and physically able to participate safely in these activities. *
Required
LIABILITY RELEASE: In consideration of Bullard First United Methodist Church allowing the Participant to participate in a community wide Personal Safety & Self Defense Class at the church’s facilities, I, the undersigned, do hereby release, forever discharge and agree to hold harmless Bullard FUMC, its pastors, directors, employees, trustees, volunteers and teachers (collectively herein the “Church”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in this activity. The undersigned further hereby agrees to hold harmless and indemnify said Church for any liability sustained by said Church as the result of the negligent, willful or intentional acts of said Participant, including expenses incurred attendant thereto. *
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