Registration
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Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Home Phone:
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
City:
*
State:
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
*
Students entered below will be added to your family's account
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Additional Information:
Assumption of Risk
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I acknowledge and understand the potential risk of injury, of contracting viruses, and other dangers inherent in obstacle training and other athletic or social activities sponsored by Freeport Ninja Academy (Real Life Ninja Corp. parent company), and I acknowledge the assumption of those risks for myself and all others listed on my account.
I allow Freeport Ninja Academy (and it's parent company Real Life Ninja Corp.) to use photographs and video of me and all others listed on my account, including children, for promotional purposes, including but not limited to on the internet, websites, social media, advertising or other media. No names will ever be posted.
I've read the above and agree.
Release of Liability
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For and in consideration of athlete's registration with Freeport Ninja Academy (parent company Real Life Ninja Corp.), I as an athlete or as an athlete's parent and/or legal guardian or representative of other family members on my account, hereby release and forever discharge covenant not to sue, and agree to indemnify and hold harmless Real Life Ninja Corp., Freeport Ninja Academy, its owners and employees and contractors, from any and all liabilities, claims, demands or causes of action that I may hereinafter have for injuries, virus contraction or transmission, or damages arising from participation in activities at Freeport Ninja Academy or events which it may sponsor or be affiliated with or activities incidental thereto. This release includes but is not limited to injuries, damages or losses or illness caused by the passive or active negligence of the released parties or hidden, latent or obvious defects with the equipment sold or used.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
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