Registration

Encore Training Registration
Student Name
Birthdate

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age
Address
Telephone
Format: (000) 000-0000.
Parents Name
Email
example@example.com
Medical ConditionsAllergies
Emergency Contacts Name and Phone#:
1
2
Class Time
Acknowledgement of Risk and Waiver Liability
As the ParentGuardian of
,I hereby give permission for my child to participate

in lessons at Encore Training, LLC. I recognize that sports training involves inherent risks and I assume those risks. On behalf of my child and on my own behalf, I agree to waive all claims against Encore Training, LLC and its owner and instructors for any liabilities, loss, cost, damage, medical expense, long-term care, or emotional distress arising out of any personal injury, including total disability, paralysis, and death, which may occur to any of our children while on the premises of or under the instruction, supervision, or control, of Encore Training, LLC. I hereby testify to my child's sound health of mind and body and authorize Encore Training, LLC to seek medical treatment at the nearest medical facility in case of emergency. I have read and understand all the above and agree.
Signature of parent or guardian
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: