Program Details
Program: ______________________ Date: ________________
Participant Information
Participant Name: ______________________
Date of Birth: _______________
Email: ______________________
Phone: ______________________
Parent/Guardian Information (if under 18)
Name: ______________________
Emergency Contact: ______________________
Phone: ______________________
Acknowledgment of Risk
I understand participation involves physical activity, self-defence techniques, and scenario exercises.
I acknowledge the risk of injury and voluntarily assume all risks.
I release KidSafeHer, its instructors, and agents from liability.
Medical & Health Information
Participant is physically capable of participating.
Known medical conditions/injuries: ______________________
Allergies or special considerations: ______________________
Consent for Minors
I am the parent/legal guardian and give permission for my child to participate.
I consent to emergency medical treatment if necessary.
Waiver & Release of Liability
I release and discharge KidSafeHer, instructors, and agents from any claims, demands, or causes of action.
I agree not to sue except for gross negligence or intentional misconduct.
Media Release
I consent to photographs or video of the participant for marketing or social media.
I do NOT consent.

KidSafeHer Participation Waiver & Release Form

Code of Conduct
I agree to follow instructor guidance, act respectfully, and participate safely.
I understand unsafe behavior may result in removal without refund.
Registration & Payment Acknowledgment
I understand classes require a minimum of 10 participants.
I understand I will be notified with a payment link and program details once the class reaches full capacity.
No payment is required until the class is confirmed.
Acknowledgment of Terms
I have read and understand this waiver and release, and voluntarily agree to its terms.
I acknowledge this is a binding legal agreement under the laws of British Columbia and Canada.
Signatures
Participant Signature: ______________________ Date: __________
Parent/Guardian Signature (if under 18): ______________________ Date: __________
Instructor/Staff Signature: ______________________ Date: __________