book your free trial

Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Parent/Guardian Name

If Applicable:

First Name

Last Name

Acknowledgement of Risks, Injury and Obligations *

I Acknowledge that the activities I am about to undertake have potential dangers and by participating in them, I am exposed to certain risks. I assume the risk of, and the responsibility of any injury, illness, death or property resulting from my participation in any activities. I also agree that in the event that i am injured or my property is lost or damaged, I will bring no claim, legal or otherwise, against Excel Martial Arts, its operator or its servants and agents, in respect of that injury, loss or damage.

Agree

Phone *

(###)

###

####