SOUTH DENVER FENCING ACADEMY, LLC

Last Name: ____________________   First Name: ___________________   MI: ______  

Street Address: ___________________________________________ Apt # ____________  

City: ________________________ State : ________ Zip Code: __________-_______  

Emergency Phone #’s    Home: __________________________

Cell (Mom): _________________________        Cell (Dad): ____________________________  

Date of Birth _____/_____/________

  ***ALL PARTICIPANTS MUST WEAR LONG PANTS AND SNEAKERS*** 

WAIVER OF LIABILITY - SOUTH DENVER FENCING ACADEMY , LLC  

I understand and appreciate that the participation in fencing as a sport carries a risk to me of serious injury, including permanent paralysis or death.  I agree to abide by the rule of South Denver Fencing Academy, LLC and the United States Fencing Association.  I enter the classes and events sponsored by South Denver Fencing Academy, LLC voluntarily and at my own risk, and knowingly recognize, accept, and assume this risk and release South Denver Fencing Academy, LLC, the United States Fencing Association, and their sponsors, employees, agents, contractors, volunteers, event organizers, and officials from any and all liability.  

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Fencer’s Printed Name  

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Signature of Parent or Guardian for Minor                                   Date