Evergreen Taekwondo Academy Waiver Form

Personal Information

Full Name *

Email *

Phone Number *

Date of Birth *

Address

City

State

Zip Code

I am signing for a minor (under 18 years old)

Emergency Contact Information

Emergency Contact Name *

Emergency Contact Phone *

Relationship to Emergency Contact *

Medical Information

Medical Conditions (if any)

Current Medications (if any)

Allergies (if any)

Waiver and Release

I hereby acknowledge and understand that participating in Taekwondo and other martial arts activities involves certain risks, including but not limited to serious injury, disability, or death. By signing this waiver, I voluntarily assume all risks associated with participation in activities at Evergreen Taekwondo Academy.

I, for myself, my heirs, executors, and administrators, hereby release, waive, and discharge Evergreen Taekwondo Academy, its instructors, employees, volunteers, and representatives from any and all liability, claims, demands, actions, and causes of action arising out of or related to any loss, damage, injury, or death that may be sustained by me or my child while participating in any activity at or sponsored by Evergreen Taekwondo Academy.

I also authorize Evergreen Taekwondo Academy to seek medical treatment for me or my child in the event of injury, and agree to be financially responsible for any costs incurred as a result of such medical treatment.

I have read, understood, and agree to the terms and conditions of this waiver and release of liability.

Signature *