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Birthday

Declaration

In completion of this form of application to Team Energize, I accept that practicing in Martial Arts carries the risk of serious injury and I hereby exonerate Team Energize from losses, either personal, or of article, or injury of any nature or cause whatsoever. I further declare that I am fit to train in kickboxing and in good health.

Signature of parent/guardian is required if applicant is under the age of 18 years old.

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