FREE Trial Fencing Class Form - Fencing Academy of Boston

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Free Fencing Class

- Step 1 of 22

Fencer's Name *

First

Last

Email *

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Fencer's Gender at Birth *

Male
Female

Fencer's Age *

18 or over
Under 18

Year of Birth

Parent or Guardian's Details

Name of Parent or Guardian *

First

Last

Phone of Parent or Guardian

Email of Parent or Guardian *

Your relationship to the Fencer *

Parent or legal guardian
Other

Please specify your relationship to the child

Fencer Requirements

Choose a Beginner Class: *

Free Youth Intro Fencing Class. Age (9-14)
Free Adult Intro Fencing Class. Age 15+

Total class cost

$0.00

Emergency Contact

Please provide an alternative contact person in case of emergency. Emergency contacts must be over the age of 18 and capable of caring for the child if you are unavailable.

Emergency Contact's Name *

First

Last

Emergency Contact's Phone Number *

Emergency Contact's relationship to the child *

Please provide details

Waiver and Consent Form

Place "sign" in the space after reading each paragraph to indicate your acceptance.

Assumption of Risk Signature *

Clear Signature

Fencing, like any athletic activity, involves physical exertion and risk of injury. Fencers and spectators assume the risk of any injury or medical condition arising from their participation in fencing at Fencing Academy of Boston.

Waiver of Liability Signature *

Clear Signature

I understand and appreciate that participation in a sport carries a risk to me or the minor under my guardianship of serious injury, including permanent paralysis or death. Intending to be legally bound, I hereby release for myself, any minor under my guardianship, heirs, executors, and administrators, any and all rights and claims for damages against the Fencing Academy of Boston, its sponsors, coaches, instructors, officials, members, guests, associates, investors, and other participants, and the United States Fencing Association, for any and all injuries or loss or damages incurred as a result of participation in the Fencing Academy of Boston fencing program or any use of its facilities.

Consent to the Code of Conduct Signature *

Clear Signature

I have read and accept my responsibility and any minor under my guardianship’s responsibility to abide by the Fencing Academy of Boston’s Code of Conduct attached hereto.

Additional Consent Signature *

Clear Signature

I give my permission for my minor child or ward to participate in Fencing Academy of Boston programs, classes, and lessons.

Images and Identification Signature *

Clear Signature

I grant permission to Fencing Academy of Boston to use, reproduce, distribute and/or publicize my photographic likeness and/or the photographic likeness of the minor under my guardianship with or without identification. Publication, use and distribution of any photographic likeness of myself or my child or ward may be by any means and in any media, including brochures, pamphlets, instructional materials, newspapers, magazines, television, books, social media, Internet, and web pages. I understand that consent is voluntary and may be revoked in writing at any time.

Signatures Above

Signatures above indicate that the above information is true and correct, that the required fees will be paid, and the Assumption of Risk, Waiver of Liability, and Consent to the Code of Conduct are agreed to and accepted by me on my behalf or on behalf of a minor under my guardianship