Register Online
Please fill out and submit this form to sign-up for Integrity Martial Arts classes.

Find out about future Integrity Martial Arts events in the upcoming months by looking at the calendar, or a listing of events.

Registration: All fields are required to be filled out. Thank you for your interest, and please call or email with any questions.

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Agreement Length:	One Month Month to Month Six Months One Year Two Year
Parent, guardian, or adult participant name (First, Last):
Date of Birth:
Relationship to Student (if not self):
Address (include city, state and zip):
Home Phone:
Work Phone:
Email Address:
Student 1 Name (first and last):
Student 1 Date of Birth:
Student 2 Name (first and last):
Student 2 Date of Birth:
Student 3 Name (first and last):
Student 3 Date of Birth:
What classes will you be attending (check all that apply)?:	Mini Moosa (4-6 year olds) Children (7-12 year olds) Adult (12 and up) Cardio (12 and up)
When would you like classes to begin? (mm/dd/yy, no Sundays or holidays, please):
Liability Waiver and Consent to Participate I do hereby give my permission and consent for myself and/or my child(ren) to participate in programs and activities sponsored by Integrity Martial Arts LLC as set forth on this Registration Form. I understand that the activity for which I have completed this Registration Form may involve some risk of injury. I further understand that I and/or my child(ren) is participating at mine and/or his/her own initiative, risk, and responsibility. I have had all my questions answered for me regarding the programs and activities, and I have received full disclosure of what the activities will be from Integrity Martial Arts LLC. Therefore, in consideration of permission extended to me by Integrity Martial Arts LLC, through its officers and agents, to allow myself and/or my child(ren) to take part in these programs and activities, I do hereby for my child(ren), myself, and our heirs, personal representatives and assigns, knowingly and intentionally remise, release, and forever discharge and agree to hold harmless and to indemnify and defend Integrity Martial Arts LLC and all of its officers, agents and employees, acting officially or otherwise, from any and all claims, demands, actions, or causes of action on account of any injury or death to myself and/or my child(ren), or damage to my and/or my child(ren)'s property which may occur from any cause during said programs or in connection with any activities incidental thereto. Emergency Medical Care I further authorize Integrity Martial Arts LLC, its officers, agents and employees to arrange emergency medical care for myself and/or my child(ren), solely at my expense, should it become necessary to do so in the event of injury to myself or child(ren). I have read the above statements and agree to its terms.* *You must check the button to agree with the above statement to submit this form.

 

Please review the information above before submitting this form. Thank you for participating.