Jeff Horn AMAYDA Resilience and Empowerment Programs
Complete the enrolment form, in full, to book a place for your child in Australia’s No. 1 Resilience and Empowerment program at your school today!
School
*
St Johns Anglican College Term 4, week 1 - Tuesday 3:30pm to 4:30pm
Pallara State School Week 1 Term 4, Thursday 3pm - 4pm
Bellbird Park State Secondary College, Week 3, Term 4 3:15-4:15pm
Bellbird Park SSC 2022 ENROLLMENTS
Pallara State School 2022 Enrollments
How Many Children
*
Price
Child's Full Name
*
First Name
Last Name
Parent's Full Name
*
First Name
Last Name
E-mail
example@example.com
Contact Number
Billing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I understand the risks include
*
I fully realize the dangers of participating in an activity of this type (Martial Arts) and voluntarily assume all the risks associated with such participation.
I agree that it is our sole responsibility
*
I agree that it is our sole responsibility to be familiar with the physical and mental demands associated with this activity (Martial Arts).
I understand that there may be video photography and/or still images being recorded at this event
*
I hereby release use of said images/video to the facilitators of this event, with no expectation of compensation, monetary or otherwise.
COVID 19 Waiver
*
I acknowledge the contagious nature of the Coronavirus/COVID-19. I voluntarily seek services provided by AMAYDA Pty Ltd and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending my appointment.
Read
FULL WAIVER
here.
I have READ FULL WAIVER
*
I hereby certify I READ THE FULL WAIVER and acknowledge it.
Submit
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