To register yourself or your teen, please complete all parts of this registration form, below, and click on the “Register Now” button. Attendee is required to wear comfortable or loose workout clothing and comfortable running- or tennis-type sneakers.
1. Student information:
Attendee Name:* Age:* Minimum age 12
2. Attendee or contact information:
Adult or Parent's Name:*
Adult or Parent's Phone Number:* (ex. 123456789)
Email address:* (ex. jsmith@mail.com)
Mailing Zip Code:*
3. I am registering for the following session(s):
July 24, 2010 (2:00-4:00 p.m.) August 28, 2010 (2:00-4:00 p.m.)
Terms and Conditions:
Please read this important statement before submitting this form:
By submitting this Registration Form, I indicate that I have read and agree by participating in this Self Defense Workshop that I or my teen may risk bodily injury and knowingly and freely assume all risk for myself and or my teen. I release and hold harmless and nor hold legally responsible the RBCPC, TEMAS or MANNA’S with respect to any injury except that which results from negligence or willful misconduct. I and/or my teen have been made aware of the safety rules of the Self Defense Workshop and give my permission for him/her to participate in this Self Defense Workshop.
Do you agree to the Terms and Conditions? Yes
* Required information