United Schools of Survival - Kansas City Registration

United Schools of Survival - Kansas City Registration

Please fill out 1 application per Student. If a family, you will receive one invoice with all members combined.
Personal Information
Name of Student

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Date of Birth

MonthDayYear
Date
Parent or Guardian if under 18

First NameLast Name
Emergency Contact
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Relationship

Training Packages

Prices Arranged by Age Group
Type a question

Children Ages 5 - 7 $75.00 Per MonthChildren ages 8 - 17 $75.00 Per MonthAdults Ages 18 & up $95.00 Per Month
Waiver of Liability
I hereby submit my application for membership with USOS Kansas City School of Martial Science. I clearly recognize that a risk is involved in participating with this training and related activities. Perspectives members attest that he/she is physically fit to participate with this system of training.

In consideration thereof, I hereby waive, release, and forever discharge the USOS Kansas City School of Martial Science, Grandmaster Anthony Muhammad, The United Schools of Survival Federation, all participants and members on behalf of my heirs, my executors, my administrators and assigns of any and all claim, rights, or causes of action whatsoever for any damages or injuries which may arise traveling to, participating in, returning from classes, or which might arise thereafter, against any person or entity in any way connected with the instruction of this martial art. The parents and or guardians of the applicants hereby request that this application be accepted, and in consideration thereof, agree to indemnify and release all members of the USOS Kansas City School of Martial Science, Grandmaster Anthony Muhammad, The United School of Survival federation, all participants and members, from all claims made or which may be made on behalf of the applicant for the aforesaid consideration. I understand all fees are non-refundable.
Photo / Video Release
I hereby agree that any photographs and or videos taken during my participation of activities with the USOS Kansas City School of Martial Science may be used for publicity or any other use seen fit by the USOS Kansas City School of Martial Science, Grandmaster Anthony Muhammad and the United Schools of Survival Federation without any compensation to my parents, guardians, or myself. I hereby waive any rights I may have to inspect or approve and photographs and or videos of myself.
Signature of Applicant
Signature of Parent or Guardian
Should be Empty:

United Schools of Survival - Kansas City Registration

Personal Information

Emergency Contact

Training Packages

Waiver of Liability

Photo / Video Release