Oyster Bay Jiu-Jitsu
**ENROLLMENT AND ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM**
Participant's Name
*
First Name
Last Name
Participant's Email
*
example@example.com
Participant's Phone
*
Participant's Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Date of Signature
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Please check this box if you don't want any photos posted to Oyster Bay Jiu Jitsu social media accounts. We always have our member's feelings forefront when we use photos.
Please dont use any photos
Participant Signature
*
Parent/Guardian Signature
If under 18 years old, Parent or Guardian must also sign
When you submit the form, you will be directed to the payment page.
Submit Form
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