Adult Registration Form

AxeCV Adult Registration Form

Fill out the form carefully for registration.
Client Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Gender*
Client E-mail*
example@example.com
Mobile Number*
Phone Number
Which classes are you interested in? Select all that apply

Afro-Brazilian danceStrength circuitIntro CapoeiraMixed CapoeiraAll classes
Payment Option*
Payment type (must choose credit card for monthly subscriptions)*
Allergies, injuries, health issues etc. if none please type (none).*
Liability Waiver The below is a standard legal liability waiver. If at any point you do not feel comfortable to do any of the exercises please refrain from doing so and the teacher will help to modify for you. Also make sure to release any information regarding your health and wellness that would be of importance to your teacher. All drugs prescription and otherwise must be disclosed and all medical conditions especially heart or joint conditions. All participants in training packages online and use of the facility shall be undertaken at his or her sole risk and the trainer or facility shall not be liable for any injuries or damage to any member/client or guest or be subjected to any claim, damage whatsoever, including without limitation, those damages resulting from acts of active or passive negligence on the part of AxeCV, its officers, agents,or employees, or Covid related injuries or contagion within AxeCV classes or facilities. The client for himself/herself and on behalf of his/her executers administrations assigns and successors does hereby expressly forever release and discharge the trainer/AxeCV,its successors and assigns, as well as officers, employees and agents from all such claims demands injuries or damaged received or sustained by a member, guest, or visitor brought to the place of business to utilize the facilities. You will also be required to fill out a full waiver upon entry of the Axe CV Academy.

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My Products - please choose ONLY if paying by credit card.

Afro-Brazilian dance fall session Mondays 6:15pm. Sept 16 - Nov 18th

$169.00CAD Quantity

1 day per week Adult classesChoose any single class and you will be auto billed after the first month if you choose to continue

$80.00CAD Quantity

2 days per week of any Adult classeschoose any two classes per week. monthly autopay will start after your first month unless you choose not to continue

$129.00CAD Quantity

Unlimited Adult classes For three days or more of any Adults classes. You will be auto billed at the end of the first month if you choose to continue.

$160.00CAD

Subtotal

$0.00CAD

Tax

$0.00CAD

Total

$0.00CAD

Credit Card

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AxeCV Adult Registration Form

Credit Card