Event Participation
Liability Waiver

Required for non-members to participate in any events at Eagle Rock

PARTICIPANT INFORMATION

First Name

Last Name

Date of Birth

PARENT/GUARDIAN INFORMATION (required if participant under 18)

First Name

Last Name

Date of Birth

Relationship to Participant

CONTACT INFORMATION

Home Address

City

State

Zip Code

Primary Phone

OTHER INFORMATION

Which event are you participating in?

Have you been referred by any of our current member? If so, what is the name of the member?

Are you interested in finding out more about our programs?

I (the parent/guardian if participant under 18) agree to the terms & conditions: I hereby claim that the Participant is in good physical condition and is able to use the equipment provided and participate in activities and martial art programs made available by Eagle Rock Martial Arts (ERMA). ERMA represents that its personnel have no expertise in diagnosing, examining, or treating medical conditions of any kind or the effect of any specific exercise on any medical condition. I recognize and understand that martial arts is a physical contact activity and that the Participant’s participation might result in serious injury, death, and/or severe social & economic loss. I hereby waive all claims against ERMA and all persons connected with ERMA for any injuries/loss that I (the Participant) may sustain during participation in any activities, events and/or said martial arts instruction. Furthermore, I and the Participant agree to abide by all rules & regulations of ERMA.

Signature (parent/guardian if participant under 18)

Taekwondo & Leadership Academy

Event Participation Liability Waiver

Event Participation
Liability Waiver