2009 Alliance Winter Camp
Junior/Adults. Advanced. December 27-31, 2009 Daily 10:00am - 4:00pm
Student
Name: ______________________________________
Age: _____ Gender: M , F (circle one)
Address:
___________________________________________
Home
phone: __________________
E-mail:
____________________________________________
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 injure, 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.
Amount enclosed: ____________
Fencer signature _________________________
Parent signature _________________________
(Required for fencers under 18)
Date: ___/___/___