Student Surname
Student First Name
Age
Date of Birth
Home Address
Telephone
Medical conditions that might interfere with training:
How did you hear about PALMISTE TAEKWON-DO?
DATE
Email
If Applicant is under the age of 18 Parent or Guardian please provide the following information.
Name of Parent or Guardian
Relationship to Applicant
Email
Telephone
Home #
Cell #
Work #
LIABILITY WAIVER
I fully recognize and acknowledge that Taekwon-Do is a contact sport and may result in physical injury to myself, my child and/or others. Having a full understanding of these risks, I and or my child wish to participate in the classes. I assume full and complete responsibility for any and all damages or injuries that I and or my child may sustain or incur, if any, while participating in any Taekwon-Do activities. I do hereby release and further discharge Palmiste Taekwon-Do’s owners, operators, any assistant instructors, or employees, as well as the Trinidad and Tobago Taekwon-Do Federation and the International Taekwon-Do Federation, for any personal injury that I and or my child may sustain while attending any class or activity. I also realize and acknowledge that I am solely responsible for any medical attention or treatment that I or my child may need as a result of my and or their participation.
FOR PARENTS/GUARDIANS: By signing this Liability Waiver, I fully recognize and acknowledge that Taekwon-Do is a contact sport and may result in physical injury to my child/ward. Having a full understanding of these risks, I permit my child and or ward to participate in the classes. I assume full and complete responsibility for any and all damages or injuries that he or she may sustain or incur, if any. I do hereby release and further discharge The Palmiste Taekwon Do’s owners, operators, any assistant instructors or employees and the Trinidad and Tobago Taekwon-Do Federation and the International Taekwon-Do Federation, for any personal injury that my child and or ward may sustain while attending any class or activity. I also realize and acknowledge that I am solely responsible for any medical attention or treatment that my child and or ward may need because of his/her participation.
Photo and Video Release:
I hereby grant the Palmiste Taekwon-Do the Trinidad and Tobago Taekwon-Do Federation and the International Taekwon-Do Federation. permission to use myself, my son(s), my daughter(s) likeness in a photograph and or Video in any and all of its publications, including websites, Facebook, Instagram, Tik Tok, Twitter, and all other social media platform entries, without payment or any other consideration. I understand and agree that these materials will become the property of Palmiste Taekwon-Do and will not be returned. I hereby irrevocably authorize Palmiste Taekwon-Do to edit, alter, copy, exhibit, publish or distribute these photos and Videos for purposes of publicizing Palmiste Taekwon-Do and Trinidad and Tobago Taekwon-Do Federation’s programs. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein myself/son(s)/daughter(s) likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph and video.
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