Friday December 13th from 7pm to 9am the next day!!!
What a perfect time to have a relaxing dinner together, go to a christmas party, wrap some gifts, or just spend some time without the kids!
December 13, 2013 7:00pm - December 14, 2013 9:00am
226 Waverley Road Dartmouth NS B2X 2C4
Please note that this form contains limited capacity items which are sold out. They are displayed grayed out and are not selectable.
• = required field
Child's First Name
Child's Last Name
How old in years is your child?
Example - I'm 12 years old add in to the field 12
Mother's Cell Phone Number
Father's Cell Phone Number
Emergency Contact number for this night
If you are unavailable is there a grandparent / friend etc that can be contacted in your absence. Please add the phone number and name
What program is your child attending from?
If you select Judge or Official select this and NOT your belt level (if applicable) in the next section. (as you will not be charged any fee)
Any Medical Risks or Known Allergies?
If Medical Risks or Allergies, please indicate below:
Any special instructions concerning your child
If so what are they?
I hereby agree to attend, or, if applicable, agree that I am legal guardian of the registrant and give my permission for him/her to attend, this event. For myself, or as legal guardian of the registrant, I hereby hold harmless, release and forever discharge the School, and its instruc≠tors, members, agents, employees and authorized representatives from any liabil≠ity, claim, loss, including but not limited to personal injury or expense incurred by me or the registrant and arising from my, or the registrantís participation in this event, whether or not caused by the negligence of the School, its instructors, members, agents, employees or authorized representatives. I, for myself, or on behalf of the registrant, specifically understand and agree I am assuming the risk of any and all injuries that I or the registrant may suffer or incur as a result of participation in this event.
Check this box to indicate that you have read and agree to all of the above terms & conditions
Electronic signature of Parent/Guardian or Participant over 18 years of age
Simply type your name in the field provided.