Waiver

Participant Name *

First

Last

Does the participant have any known allergies, disabilities, things you would like us to know?

Guardian and/or Emergency Contact Information

Please enter the name of the parent or guardian who should be contacted in the case of an emergency.

Name *

First

Last

Email *

Phone *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Release for Liability and Disclaimer Waiver *

I have read the disclaimer and agree to the terms for my registration.

By checking the above box, I understand that my registration is non-refundable. Memberships and subscriptions must be canceled 30 days in advance. This agreement releases Girl with Grit Program and its affiliated parties from all liability related to injuries that may occur at any location at any class, camp, workshop, or event, regardless of whether injuries or contraction of illness are caused by negligence. I swear that I am participating voluntarily, and that all risk has been made clear to me. I forfeit all right to bring a suit against Girl with Grit Program and it's affiliated parties for any reason, in return, myself or my child will receive participation in Girl with Grit Program. I will ask for clarification when needed. All students must adhere to a basic code of conduct and posted facility rules.

Release for Photos and Video

Yes
No

Signature