Registration
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Waiver for all parties and events
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:
*
Emergency Contact Info (Not Contact #1 or #2)
Students entered below will be added to your family's account
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Additional Information:
Assumption of Risk
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I knowingly and voluntarily assume all risks, both known and unknown, foreseeable and unforeseeable, associated with my presence and the presence of any minor listed on my account at Monroe Ninja Academy. This assumption applies whether participating, observing, waiting, spectating, coaching, or merely walking through or near training areas.
I acknowledge and understand that being present at and participating in activities at Monroe Ninja Academy involves inherent and significant risks, including but not limited to serious physical injury, permanent disability, paralysis, death, illness, and exposure to or contraction of communicable diseases. These risks include, but are not limited to, falls, collisions with obstacles or other participants, equipment failure or misuse, physical exertion or overexertion, slips, trips, impacts, and environmental or biological hazards.
I've read the above and agree.
Release of Liability
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I acknowledge that I am either an adult participant signing on my own behalf, or the parent or legal guardian of a minor participant, or an authorized representative with legal authority to act on behalf of such individual.
On behalf of myself and, if applicable, any minor listed on my account, I hereby release, waive, discharge, and hold harmless Monroe Ninja Academy, its owners, officers, employees, coaches, volunteers, agents, contractors, and affiliates from any and all claims, demands, damages, causes of action, or liability arising out of or related to injury, illness, loss, or damage sustained while on the premises or participating in any activity, including claims resulting from ordinary negligence, to the fullest extent permitted by the laws of the State of Connecticut.
This release is intended to be binding upon the undersigned, and if applicable, the minor participant, as well as our respective heirs, executors, administrators, and legal representatives.
I've read the above and agree.
Participation
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To participate in a Ninja Party, the child must be in sneakers, at least 5 years old by the day of the party, and below the age of 15.
I've read the above and agree.
Media Release
(Show-Hide Details)
I grant Monroe Ninja Academy permission to use photographs and video recordings of myself and all individuals listed on my account, including minors, for promotional, marketing, and social media purposes. I understand that names will not be posted in connection with such media.
If I do not wish to be included in photos or videos, I understand that I must indicate this preference by submitting a written request via email to Monroe Ninja Academy. I acknowledge that reasonable efforts will be made to honor this request, but that incidental or background appearances may still occur.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
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