AR Training Centre
Participant Registration Form
Participant Name
*
First Name
Last Name
Birth Date (Minors only)
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Day
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Year
Gender
Please Select
Male
Female
N/A
Address
Street Address
Street Address Line 2
City
Province
Postal Code
Phone Number
-
Area Code
Phone Number
E-mail Address
Parent/Guardian Name
First Name
Last Name
Parent/Guardian Phone Number
-
Area Code
Phone Number
Parent/Guardian E-mail Address
example@example.com
Parent/Guardian/Emergency Name
First Name
Last Name
Parent/Guardian/Emergency Phone Number
-
Area Code
Phone Number
Parent/Guardian/Emergency E-mail Address
example@example.com
Discipline
Please Select
Brazilian Jiu-Jitsu (Ages 7+)
Capoeira (Ages 4+)
Muay Thai (Ages 13+)
Preferred Classes
Mondays, Wednesdays, Fridays, Saturdays or All
Medical Concerns (if any)
Use of Image Consent
*
"I hereby grant AR Training Centre the irrevocable right to use at their sole discretion any information, photos and/or videos of or about the participant for publicity, advertising or any other promotions of AR Training Centre. I understand that this may include written, pictorial or video materials."
Liability Waiver - Please read and check box to affirm that you have read and understand the corresponding statement.
*
"I, Participant and Parent/Guardian (if participant is a minor) named above, have enrolled, or have allowed my child to enrol in the personalized health and fitness program offered through AR Training Centre. I recognize that the program may involve strenuous physical activity including, but not limited to, muscle strength and endurance training, cardiovascular conditioning and training, and other various fitness activities. I hereby affirm that the participant is in good physical condition and does not suffer from any known disability or condition which would prevent or limit participation in this exercise program. I acknowledge that enrollment and subsequent participation is purely voluntary and in no way mandated by AR Training Centre."
Liability Release - Please read and check box to affirm that you have read and understand the corresponding statement.
*
"In consideration of participation in this program, I hereby release AR Training Centre and its agents from any claims, demands, and causes of action as a result of my voluntary participation and enrolment. I fully understand that the participant may be injured as a result of enrollment and subsequent participation in this program and I hereby release AR Training Centre and its agents from any liability now or in the future for conditions that the participant may obtain. These conditions may include, but are not limited to, heart attacks, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, heat prostration, injuries to knees, injuries to back, injuries to foot, or any other illness or soreness that may occur, including death."
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