Test 2 - YWCA Saskatoon

Participant Registration Form

Thank you for registering for the Women’s Self-Empowerment Course! Please complete this form and submit it prior to the start of the class.

Participant Information

Full Name:(Required)

Phone Number:(Required)

Email Address:(Required)

Emergency Contact Information

Emergency Contact Name:(Required)

Emergency Contact Phone Number:(Required)

Your Relationship to Emergency Contact:(Required)

Health and Medical Disclosure

Do you have any medical conditions, injuries, or physical limitations that may affect your participation in the course:(Required)

Yes

Please list any medical conditions, injuries, or physical limitations that may affect your participation in the course:

Waiver and Release Form

Your safety and well-being are our top priorities. Please carefully read and sign this Waiver and Release Form.

Acknowledgement of Risks

I understand and acknowledge that participation in self-defence activities involves inherent risks, which may include, but are not limited to:

Section Break

● Physical exertion and possible overexertion. ● Contact with other participants and instructors. ● Potential for slips, trips, and falls. ● Risk of sprains, strains, bruises, or other injuries. ● Unexpected incidents resulting from the physical nature of the activities.

Release of Liabilty

Proper Use of Skills

I acknowledge that the self-defence skills taught during this course are intended for use exclusively in life-or-death situations. I understand and agree that these techniques must not be used under any other circumstances, including but not limited to acts of aggression, retaliation, or conflict resolution. By clicking the box, I confirm my understanding and acceptance of the risks, release the above-named parties from liability, and agree to use the learned skills responsibly and ethically.

Participant Agreement

Participant Name:(Required)

Participant Signature:(Required)

Date(Required)