Registration Form
Alliance Fencing Academy, Houston
2008 Summer Camps. Preparation for Summer Nationals
Junior/Adult advanced fencers
___June 9-13, ___June 16-20
Student
name: ______________________________________
Age: _____ Gender: M , F (circle one)
Address:
___________________________________________
Home
phone: __________________
E-mail:
____________________________________________
Parent name: ______________________________________________
In case of emergency please call: __________________________ , ___________________________
(Name) (Phone)
Alliance Fencing Academy, LLC is a member of the United States Fencing Association (USFA) with
its certified insurance.
_____ (Initial) WAIVER OF LIABILLITY
Upon entering events sponsored by the USFA and/or its member Alliance Fencing Academy, I agree
to abide by the rules of the USFA, as currently published (www.usfencing.org). I understand and appreciate that participation in a sport carries a risk to me of serious injury, including permanent paralysis or death. I voluntarily and knowingly recognize, accept and assume this risk and release the USFA, their sponsors, event organizers and officials from any liability.
Fencer/Parent signature ______________________________________ Date: ___/___/___
(parent signature required for fencers under 18)
Amount Enclosed: $ ______