Private Class Waiver

Private Class Liability Waiver Form

Do you have any medical conditios that prohibits you from participatng in an intense sports activity?

Yes

QUALIFIED HEALTH The student warrants and represents that he/she is physically, mentally and emotionally fit to participate in the activities offered in this session and that he/she has no disability, impairment or ailment that would present a health risk as a result of such participation. If you have any injuries, physical limitations or any doubt as to your condition, you should consult your personal physician prior to engaging in these activities.

DISCLAIMER AND RELEASE OF LIABILITY The Student understands and acknowledges that there is inherent risk associated with many physical activities including the practice of Krav Maga and other forms of self-defense. Student and or legal guardian voluntarily accepts these risks and hereby releases Haim Levy, Traditional Krav Maga of NJ Instructors, International and any other affiliated organizations, other students, and other participants in connection with Traditional Krav Maga from any liability that might arise as a result of any injury that may occur. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.

CANCELATION POLICY ACKNOWLEDGEMENT: I understand that all private class cancellations must be done at least 3 hours in advance. Cancellations made less than 3 hours before class will carry $30 charge. No show charge fee is $80.

I declare that the information I’ve provided is accurate & complete. I am 18 years of age or older and I am autorized to sign this form

Signature Date required

Student Signature (Parent/Legal Guardian if Student is under 18 years of age)

Waiver Submitted! See you on the mat!

Traditional Krav Maga of NJ
- The Passion to Empower -

Private Class Liability Waiver Form

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