Registration/ Waiver

ALL SAINT'S CATHOLIC SCHOOL REGISTRATION FORM

Please Print and return

Classes

Pre-k-K: Mondays 2:15-2:45pm

$200 per Semester

1st -5th Grade: Mondays 3:00-3:50pm

$300 per Semester

Program lasts the duration of the school year.

If you have questions, feel free to contact:

Phone: 561-252-1325

Email: thea4sd@gmail.com Remember to find us on Facebook!

Date: / /

Name of Participant (s):_____________________________________________________________

Parent Names:_______________________________________________________________________________

City: State: Zip:

Mobile Phone:

E-Mail:

Home Work Mobile

Alternate Phone:

Child Age:

Date of Birth: ____ / ____ / ____

Objective / Area(s) of Interest:

Anything we should be aware of?

Prior Injuries / Physical limitations:

I am aware that Aitken Martial Arts / The Alliance for Self-Defense posts pictures and video of classes and events online to promote the dojo and I give permission for them to do so should my children or myself be in the post by signing the waiver below.

Waiver of Injury:

I hereby release and agree to hold harmless the owners of the premises, participants, and representatives of all of them (Glen R. Aitken Jr., Aitken Martial Arts / Alliance for Self-defense instructors) from any loss, damage, or injury (including death) to my person, children, and property, in anyway resulting from or arising in connection with this or any cause whatsoever. I know the risk and damage to myself, children, and property while on said premises or while participating or assisting, so voluntary and in reliance, upon my own judgment and ability, I hereby assume all risk for loss, damage, or injury (including death) to myself, children, and property from any cause whatsoever.

___________________________________________________________

Signature of Parent or Guardian

The Alliance For Self-Defense

(561) 252-1325