Holiday Camp Form

Parent Information

Address

Phone

Email

Emergency Contact

Child 1 Information

Date of Birth

Age

Gender

Allergies

Medical Conditions

Child 2 Information

Date of Birth

Age

Gender

Allergies

Medical Conditions

Choose Your Days

Please choose below the number of days for this holiday camp.

Please input HOW MANY CHILDREN (NOT PRICE) for this holiday camp in the quantity field. (ONE DAY FROM 8th OCTOBER TO 10th OCTOBER)

1 Child

+ First Sibling

+ Second of More Siblings

Please input HOW MANY CHILDREN (NOT PRICE) for this holiday camp in the quantity field. (TWO DAYS FROM 8th OCTOBER TO 10th OCTOBER)

1 Child

+ First Sibling

+ Second of More Siblings

Please input HOW MANY CHILDREN (NOT PRICE) for this holiday camp in the quantity field. (THREE DAYS 8th, 9th, 10th OCTOBER)

1 Child

+ First Sibling

+ Second of More Siblings

Total Amount

Other People Authorised to Collect Your Children

Photography

What They Need

Parent Declaration

Date

Any Additional Information or Notes

Refund & Missed Session Policy

Waiver and Release

I hereby WAIVE AND RELEASE TRIFU DOJO (to be known as the “Released Party”) from liability pertaining to the matters set forth below. I understand that by submitting this Waiver and Release, I express and willingly agree to assume complete responsibility for any risk of injury that may arise from the below related activity. On behalf of myself, my child, my heirs, my assigns and next of kin, I waive all claims for damages, injuries and death sustained to me (or my child) or my property that I may have against the above named Release Party relating to such activity. I understand that the activities I or my child will participate in may be dangerous and may cause serious injuries, including bodily injury, damage to personal property. By this waiver, I assume any risk, and take full responsibility and wave any and all claims of personal injury, including severe bodily injury, damage to personal property relating to all activities associated with TRIFU DOJO, including but not limited to receiving lessons at the facility, using the facility and it’s equipment, practicing and engaging in Martial Arts activities, and related activities on and off the school premises. If my child is injured from said activity, I will not hold Released Party responsible even if the injuries were caused by negligence on my part or the Released Party, or any other party under or affiliated with the above named Release Party.

I do not have any physical limitations, mental ailments, physical or mental disabilities that would limit or prevent my child from participating in the above-mentioned activity, and, if required, will obtain a medical examination and clearance.

I HAVE READ AND FULLY AGREE TO THE TERMS OF THIS WAIVER AND RELEASE. I UNDERSTAND AND CONFIRM THAT BY SUBMITTING THIS WAIVER AND RELEASE I HAVE GIVEN UP CONSIDERABLE FUTURE LEGAL RIGHTS. I HAVE SIGNED THIS WAIVER FREELY, VOLUNTARILY, UNDER NO DURESS OR THREATS OF DURESS, WITHOUT INDUCEMENT, PROMISE OR GUARANTEE BEING COMMUNICATED TO ME. MY SIGNATURE submission IS PROOF OF MY INTENTION TO EXECUTE A COMPLETE AND UNCONDITIONAL WAIVER AND RELEASE OF ALL LIABILITY TO THE FULL EXTENT OF THE LAW. I AM 18 YEARS OF AGE OR OLDER / LEGAL GUARDIAN AND MENTALLY COMPETENT TO GRANT THIS WAIVER.

By submitting this form you are agreeing to this waiver