Student Information 

Emergency Contact Information 

TRAINING HISTORY

Class Fees

$25 - Weekly Drop-in Rate

$90 - Monthly Rate

$260 - Quarterly Rate (3 months)

$50 - SPT test fee (non-refundable)

Safety Waiver and Photo Release

Acknowledgement I understand that all physical training carries a risk of injury and that the instructor, teaching assistants, and Corsair Fencing are not responsible for injuries or loss suffered as the result of participating in these activities.

--Due to the Physical nature of this study:

A)  I am willing to be physically adjusted by instructor(s) to correct form and practice in order to promote safety and proper technique.

B)  I am willing to be in close physical contact with other participants and/or instructor(s) during practice and demonstration.

C)  I understand that it is MY responsibility to notify the instructor(s) or classmates if I feel uneasy or uncomfortable with any physical activity.  

--Due to the Dangerous nature of this study:

I fully understand that stage combat may involve risk of injury to myself and others.

Taking this class carries with it certain inherent risks that cannot be eliminated regardless of care taken to avoid injuries. I understand that participating in any form of physical activity, including staged combat, can be dangerous, involving risk of serious injury or death.

I hereby consent that my participation and attendance is voluntary and that I knowingly assume all such risks. Consequently I agree to accept any and all risk involved with the activities in which I choose to participate; to follow the teaching provided by the instructor(s) to help minimize the risk of injury to myself and others, and that failure on my part to abide by the rules of safety will jeopardize my eligibility to participate in this activity, and that the instructor(s) reserve the right to dismiss or remove any participant from the class without reimbursement at their discretion for unsafe or abusive behavior, and/or the blatant disrespect for teaching staff and/or participants and/or class equipment. 

I understand that the Instructor and teaching assistants, nor any other entities are responsible or liable for any injury or damage that may occur from unforeseen accidental weapon breakage, or from putting into practice the ideas and actions described in the class, nor will they be responsible for injury or damage from practicing or performing stage combat in general; I do so at my own risk. As a class member, I agree to show respect to the staff, and abide by all the class’s rules. Furthermore, I agree to conduct myself in a positive and responsible manner at all times, to promote both the success of the class and the welfare of my colleagues.

 

Photo Release:  From time to time the Instructor or teaching assistants may post photographs of our classes online in order to promote the classes to future students. I will let the instructor know by email at tonyarlynn@gmail.com if I do not consent to my or my child’s photos being shared. 

Medical Authorization In the event of an injury or medical emergency, I allow the class instructor and/or teaching assistants to provide first aid, arrange transport to a medical facility, and authorise emergency treatment as recommended by a doctor for the student named above. I understand that all reasonable efforts will be made to contact the student's parent and/or emergency contact if an injury or medical emergency occurs. I accept full responsibility for all costs of said medical care and any emergency treatments. The Instructor, teaching assistants, and Corsair Fencing will not be held responsible for the cost of any medical or dental care, or emergency treatments. I hereby waive all claims whatsoever in connection with such medical treatments.

Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.