KIDS MEMBERSHIP

KOP MUAY THAI — PARENTAL MEMBERSHIP WAIVER

CHILD’S DETAILS

Child’s Full Name: {name}

Child’s Date of Birth: {dob}

PARENT OR GUARDIAN DETAILS

Parent/Guardian Email:

Parent/Guardian Phone: {phone}

Relationship to Child:

MEMBERSHIP DETAILS

Membership: {membership_title}

Start Date: {start_date}

Membership Fee: {membership_fees}

Payment Frequency: {membership_recurrence}

MEDICAL INFORMATION

Please list any medical conditions, injuries, allergies, medication or additional needs.

Write “None” if there is nothing to declare:

PARENT OR GUARDIAN AGREEMENT

I confirm that I am the child’s parent or legal guardian and give permission for them to train at KOP Muay Thai under the membership shown above.

I understand that Muay Thai and fitness training involve physical exercise and controlled contact. Injuries may occur, including bruises, sprains, broken bones, concussion or other serious injuries.

I confirm that my child is fit to train. I will tell a coach about anything that may affect their health or safety, and my child will not train when unwell, contagious or with open cuts or infections.

I understand that my child must follow all coaching instructions, gym rules and safety requirements, including wearing hand wraps and any other equipment requested by a coach.

To the fullest extent permitted by law, I agree not to hold KOP Muay Thai, its owners, coaches or staff responsible for injury, illness, loss or damage arising from my child’s participation. This does not exclude responsibility that cannot legally be excluded.

I have read and agree to this waiver and give permission for my child to train at KOP Muay Thai.

PHOTOS AND VIDEOS — OPTIONAL

Leave this box unticked if you do not give permission.

I give KOP Muay Thai permission to use photos or videos of my child for its website, social media and marketing.

EMERGENCY CONTACT

Complete this only if the emergency contact is different from the parent or guardian above.

Emergency Contact Name:

Emergency Contact Phone:

Parent/Guardian Name:

Date Signed: {sign_date}