Free Aiki Dojo - Golden Bears Aikido - Peace Pratices Participation Waiver
This form is a legal document which must be signed as part of participation in any Free Aiki Dojo, Golden Bears Aikido Club, and Peace Practices classes.
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Personal Information
This information allows us to associate your agreement and release with you or your child.
First Name
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Last Name
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Email Address
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Phone Number
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Where do we find each other? Please select all that apply.
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Aiki Extensions
Aikido of Berkeley
Beacon Day School
Epworth UMC
The Flight Deck (Downtown Oakland)
Free Aiki Dojo - Golden Bears Aikido
Oakland, City of
Pacific Rim International School - Emeryville
Pacific Rim International School - San Mateo
Public Seminar (e.g. TSYR)
Richmond, City of
UC Berkeley
Other:
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Info required when signing for a minor - skip otherwise
Relationship to child(ren)
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Full Name of first child:
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Date of Birth of first child:
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Full Name of second child:
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Date of Birth of second child:
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Anything we need to know (medical/developmental issues/concerns?)...
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