Martial Arts Student Liability Waiver Form

Martial Arts Student Liability Waiver Form

Please complete this form with your contact details, health information, and signatures to acknowledge risks and give consent.
Student Information
Full Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parent/Guardian Information (If Student is Under 18)
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Email Address
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Information
Emergency Contact Name

First NameLast Name
Relationship to Student
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Health Conditions and Injuries
List any health conditions, allergies, or injuries the instructor should be aware of.
Assumption of Risk & Release of Liability
Assumption of Risk: I understand that participation in martial arts involves physical activity and inherent risks of injury. I voluntarily assume all risks associated with participation.

Release of Liability: I hereby release the martial arts school, its instructors, staff, and affiliates from any and all liability for injuries or damages arising from participation.

Photo/Video Release: I grant permission for the school to use photos or videos taken during classes or events for promotional purposes. If you do not consent, please notify the instructor in writing.
Student/Guardian Signature (if student is under 18)
Date Signed

MonthDayYear
Date
Should be Empty:

Martial Arts Student Liability Waiver Form

Student Information

Parent/Guardian Information (If Student is Under 18)

Emergency Contact Information

Health Conditions and Injuries

Assumption of Risk & Release of Liability