Forestb Registration Form
First Name
*
Last Name
*
Birth Date
*
Please select a month
January
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Month
Please select a day
1
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Day
Please select a year
2024
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Year
Current School
Current Belt
Please Select
none
white
yellow
orange
green
high green
purple
Blue
Blue SR
Brown
Brown SR
Red
Jr. Black
Black
Primary Phone Number
*
-
Area Code
Phone Number
Secondary Phone Number
*
-
Area Code
Phone Number
E-mail
*
Inconsideration of your accepting the Above named candiate for participation in the above named program, I hereby, for myself , my child , my heirs exectuors and administrators waive and release any and all rights and claims for damages I or my child may have against U.S Taekwondo Center LLC. and its representatives, successors, and assigns for any and all injuries suffered by myself personal and or mental injury. Damages include but not limited to acutal consequential , incident or punitive damage. This release is signed freely, voluntarily, and not under duress. I also grant permission to managing personnel or representatives to authorize medical care from any licensed physician, hospital, or medical clinic should I or my child become ill or injured while participating in activities away form home or at other sites when neither parent is available to grant authorization for emergency treatment. I realize that I am or my child is responsible for understanding and adhering to all rules and regulations of the program.I further agree to indemnify U.S. Taekwondo Center LLC, its agents,employees,representives,successors and assigns against any and all claims which may be filed against them for any damages I or my child may claim to include attorney's fees and costs for defending such claims.
Accept Wavier
*
Accept Waiver
Decline Waiver
I understand this is considered my electronic signature below sign in space provided
*
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