Defy with Aish

Defy with Aish

2/13/22 - 2:30pm-5:00pm - Boys Ages 12-14
Participants Name *

First Name Last Name
Teen Phone Number *
Please enter a valid phone number.
Teen's Email *
example@example.com
Teen Birthday *

Month Day Year
Date
How will your child get to the event? *

I will drive him Please be in touch with me about transportation
Is your child vaccinated? *

Yes No
Does your child have any allergies? *

Yes No
Please explain:
Parents name *
Parent Phone Number *
Please enter a valid phone number.
Parent Email *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Liability WaiverRelease and Indemnification
I hereby consent to my child's participation in Aish activities. I hereby release, waive, discharge and indemnify Aish, their affiliates, agents, officers, directors, supervisors, and employees (herein referred to collectively as "Aish") from and against any and all claims for property damages, liability or personal injuries which my child may sustain. I further agree to indemnify and defend against any and all claims for property damages, liabilities, or personal injuries which a third party may sustain by reason of any act or omission of my child.

Additionally, I understand that my child or children's pictures taken while participating in any camp activities may be used by Aish for their marketing purposes.
I, the undersigned parent of *
CampaignID
Signature *

Clear

My Products *

Defy Event Admission for one

$ 30.00 Quantity

Enter coupon

Total

$ 0.00