Positive Community Organization

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Event Registration & Waiver

Adaptive Martial Arts Summer Day Camp (June 22-26, 2026)

Participant Information

First Name *

Last Name *

Email *

Phone *

Age *

Registering As *

Health Information

Medical Conditions or Disabilities (optional)

Emergency Contact

Emergency Contact Name *

Emergency Contact Phone *

Waiver & Release

ASSUMPTION OF RISK AND WAIVER OF LIABILITY

I acknowledge that participation in the Adaptive Martial Arts Summer Day Camp involves inherent risks, including but not limited to physical injury. I voluntarily assume all risks associated with my participation.

I hereby release, waive, and discharge the Positive Community Organization, Southern Shaolin Academy, their officers, employees, agents, and representatives from any and all claims, demands, or causes of action arising from my participation in this program.

I confirm that I am in good physical health and capable of participating in this activity. I have disclosed all relevant medical conditions and disabilities.

I understand that the organization is not responsible for any injuries or damages that may occur during the program.

I have read and agree to the waiver and release of liability *I consent to photos/videos being taken for promotional purposes

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