Registration
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You must also register for the National Ninja league to Participate Go to https://www.nationalninja.com/ -click on waiver on bottom right.
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 Phone # & name
*
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)
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:
*
Student Gender:
Female
Male
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:
*
Student Gender:
Female
Male
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:
*
Student Gender:
Female
Male
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:
*
Student Gender:
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Questions/Options:
What is the ninja's NinjaWorks Athlete ID - Found through the NNL waiver at nationalninja.com or on last years results.
*
Additional Information:
Assumption of Risk
(Show-Hide Details)
I acknowledge and understand the potential risk of injury and dangers inherent in the sport of obstacle training and other athletic activities sponsored by New Era Ninjas., of the risk of contracting viruses and I acknowledge the assumption of those risks. I also acknowledge the risk of being inside the gym area to take pictures or video during the event.
I've read the above and agree.
Release of Liability
(Show-Hide Details)
For and in consideration of athlete's registration with New Era Ninja LLC.,I as an athlete or as an athlete's parent and/or legal guardian hereby release forever discharge covenant not to sue and agree to indemnify and hold harmless New Era Ninjas LLC, its owners and employees, from any and all liabilities, claims, demands or causes of action that I may hereinafter have for injuries or damages arising out of participation in activities at New Era Ninjas LLC, Inc. 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 caused by the passive or active negligence of the released parties or hidden, latent or obvious defects with the equipment sold or used. I allow New Era Ninjas LLC to use pictures and video of myself or my child in social media posts. Names will not be posted nor will material be used for future promotion of an event the individual is not involved in.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
Credit Card Verification:
Card Number:
*
Visa
Mastercard
Amex
Discover
Name as it appears on card:
*
Nickname:
Card Expiration Month:
*
01
02
03
04
05
06
07
08
09
10
11
12
Exp Year:
*
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
2046
2047
2048
2049
2050
Address Line 1:
Address Line 2:
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
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
PR
VI
Zip:
*
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