Application for Membership

I, the undersigned, herby apply for Membership at White Eagle Martial Arts, and I understand the following conditions:

1. My Participation is limited to the times I am assigned, and these are depends on my actions, I must follow all rules and directions or I can be suspended.
2. The facility will be closed on major holidays and reserves the right to suspend operations for no more than two weeks per year.
3. The school, its owners and/or operators are not to be held liable or responsible for any accidents or loss of personal property due to fire, theft, carelessness, or any other reason whatsoever and applicant waives the right to such claims.
4. The school, its owners and/or operators are not to be held liable or responsible for any injury or death due to instruction, practice, exhibition, or use of any knowledge or skills of the Arts or apparatus in use at White Eagle Martial Arts and the applicant waives the right to such claims for him/herself or any heirs.
5. This organization reserves the right to refuse membership to anyone for any reason.

By filling out and submitting the following form I agree that I have read and understand the rules and regulations of this establishment and the contents herein. I wish to enroll and will provide payment at or before my first scheduled class. I understand that rates are subject to change.

Personal Information

* Student Name:

* Date of Birth:

Sex: Select One Male Female

Height:

Weight:

Address

* Street:

* City:

* State:

* Zip:

Contact Information

* Email:

* Phone Number:

Guardian Information

Guardian's Names:

Others Permitted to Pick Up:

Additional Comments: