NEW MEMBER REGISTRATION FORM 2025-26

Name of Fencer

First Name

Last Name

Birthday

YYYY

Program Name

Please let us know what program the fencer will be part of.

Email Address

Of Guardian if Fencer is a minor

Phone

Of Guardian if Fencer is a minor

(###)

###

####

Full Address

Of Guardian if Fencer is a minor

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name of Guardian

If Fencer is a minor

First Name

Last Name

How did you hear about us?

WAIVER: Participating in fencing involves certain risks. Lotus Fencing Academy or its coaches will not assume responsibility for any injury incurred while participating in fencing activities given at Lotus Fencing Academy, nor will the fencing coach by liable for lost or stolen items. I, the undersigned for myself, my heirs and assigns, do hereby release coaches, assistant coaches and any other personnel affiliated with the classes, coaching and/or lessons from any and all claims for injury, death, or damage of any kind I may suffer as a result of my participation. Please sign by typing your name to acknowledge.

Signature of Fencer or Guardian, if Fencer is a minor.

Signature Date

YYYY