Registration Form
2011 Summer Camps
Alliance Fencing Academy, Houston
Youth 7-14
___ June 6-10, ___ June 13-17, ___ June 20-24, ___ June 27-July 1
___ July 25-29
___ August 1-5
Student
name: ______________________________________
DOB: _____________ Gender: M , F Fencing experience: ___________
Home
phone: __________________
E-mail:
____________________________________________
Parent name: _____________________________________________________
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.
Parent signature _________________________ Date: ___/___/___
(Required for fencers under 18)
Amount Enclosed: $ ________