Marquart's Tae Kwon Do & Kumdo

Taekwondo Class Registration Form

Marquart's Taekwondo & Kumdo - 2615 12th Ave South, Moorhead, MN
Participant Information:
Full Name*

First NameLast Name
Preferred Name
Date of Birth

MonthDayYear
E-mail
example@example.com
Phone Number*
Address*

Street Address

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CityState / Province

Postal / Zip Code
Please list any special needs/accommodations or medical concerns that we should know about:
Parent / Guardian Information:
Fill out this section if the participant is under 18 years of age.
Full Name

First NameLast Name
E-mail
example@example.com
Phone Number
Emergency Information:
Fill out this section for all participants.
First & Last Name of Emergency Contact Person*

First NameLast Name
Relationship to participant*
Phone Number*
Liability Waiver

The parent/guardian must sign if the participant is under 18 years of age.

I understand that under the terms of this agreement, the school obligates itself to furnish me with a competent instructor and facilities for teaching the lessons and that this agreement is non-cancellable. The length of time allocated for the lessons is prorated at a minimum of two lessons per week. Failure to take lessons in the allocated time invalidates the lessons beyond that date. It is further agreed that my failure to take all lessons contracted for shall not relieve me of my obligation to pay the total tuition herein agreed upon. I further understand that no refunds for any tuition paid shall be made by reason of my absence or withdrawal. Lessons are not conducted on national holidays or on days of Association-sponsored Tournaments.

In consideration of being accepted as a member, I the undersigned, agree to abide by the constitution and bylaws of this organization and all the applicable rules and regulations of Tae Kwon Do Schools and its affiliations, World Tae Kwon Do Federation or AAU. I, the undersigned, further, do hereby, for myself, my heirs, executors, administrators, and assigns; waive, release, and forever discharge any and all rights and claims for damages which I may have or which hereinafter accrue to me against School/Club, including its officers, employees, and instructors; the World Tae Kwon Do Federation or AAU, including its affiliated associations or its/their respective officers, agents, representatives, successors, and/or assigns, for any and all damages which may be sustained and suffered by me in connection with my association with, or entry in, any practice, class, contest, examination, demonstration, tournament, or athletic event of School/Club, or which may arise out of my traveling to, participating in, or returning from such endeavor.

I, the UNDERSIGNED, further agree to waive any claims against CITY OF MOORHEAD, MN, and MARQUART'S TAE KWON DO and/or Eugene Marquart, Head Instructor, connected with Tae Kwon Do Karate lessons, demonstrations, and/or Tournament Championships for any injuries I may sustain. I fully understand that "TAE KWON DO" is a contact sport, and I am responsible for my own medical coverage.
Participant's Signature*
Type Full Name
Date*

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Date
Parent/Guardian's Signature
If Participant is Under 18
Date

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Date
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Taekwondo Class Registration Form

Liability Waiver

The parent/guardian must sign if the participant is under 18 years of age.