Special Event Sign In Sheet & Parent-Child Release Form

  • Date Format: MM slash DD slash YYYY
  • Child Info

  • Child First NameChild Last NameDate of BirthAge of ChildIs Someone Else Picking Up Child 
  • By Submitting this for my Child and I have carefully read this Waiver of Liability, Medical Release, and Indemnification Agreement, and fully understand its contents. I am aware that this is a release of liability and a contract between me, my child and ACTION KARATE and we sign it of our free will.