Martial Arts Youth Registration Form

Martial Arts Youth Registration

Today's Date

Sport

Team Name (if you have one) if not, put none

Participant's First Name

Participant's Last name

Participant's Birthdate

Month

Day

Year

Parent/Guardian First Name

Parent/Guardian Last Name

Multi-line address

Country/Region

Address

City

Zip / Postal code

Phone

Emergency contact name

Emergency contact phone number

WAIVER OF LIABLITY

I, the undersigned parent/legal guardian of the child named above, understand that participation in youth sports involves inherent risks, including the risk of injury. I hereby waive, release, and discharge Houston Sports Academy, its staff, coaches, volunteers, and affiliates from any and all liability for any injuries or damages that may occur during practice, games, or related activities. I certify that my child is in good health and able to participate in the program.

PHOTO RELEASE PERMISSION

I give permission for photographs or videos of my child participating in this program to be used by Houston Sports Academy for promotional, informational or educational purposes in print, online or other media

Signature

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Martial Arts Monthly Registration

$40

Martial Arts Monthly Registration