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Medical Form and Waiver
To register to our academy please fill out the following medical form
Contact us any time
Applying on behalf of
Yourself (Adults)
Your teenager
Name
Email
Participant's Date of Birth
Emergency Contact
Emergency Contact Phone #
Do you (or your teenager) have any restrictions on participating in intense physical activities?
Yes
No
If yes, please state any restrictions/medical conditions we should be aware of:
Field label
I declare that the info I've provided is accurate and complete.
I accept the responsibility to ensure that I am medically and physically fit before starting the training at Talos Grappling.
I agree for this data to be processed in line with Talos Grappling's Privacy Policy.
I understand and accept that the sports and combat disciplines practiced at Talos Grappling are potentially hazardous, and accordingly I agree that I am aware of the risks and accept them and will personally bear all consequences of any injury I/ my child may sustain as a result of participation. I hereby expressly release Talos Grappling Academy, it's owners, employees. volunteers, other clients and agents from any actions, claims, liabilities, losses, costs or expenses arising from such injuries.
Initials
Today's Date
Thank you for submitting this form - we hope to see you on the mats soon
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