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Registration Form

2011 Summer Camps

Alliance Fencing Academy, Woodlands

Youth 7-14

 

 

___ June 13-17              ___ July 25-29          ___ August 1-5

      

 

Student name: ___________________________________________________

 

DOB: __________  Gender:    M   ,   F      Fencing experience: _____________

 

Home phone: _______________________ Cell: ________________________

 

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:  $ ________