Participant Name *

First Name

Last Name

I understand that it is my obligation to notify the workshop leaders if there are any changes to the participants health or contact details, when they attend.

For parent/carer of participants under 18.

Yes

No

I give permission for Louise Orwin & Co to take documentation of the workshop that may feature me and other participants for future publications and for internal company use. We will never name anyone in photos.

For parent/carer of participants under 18

Yes

No

Do you agree that by taking part in this workshop that you take all responsibility for any injuries on your person minor or other wise. By agreeing to this you understand that you are consenting to take part in a workshop that will involve physical fighting in a controlled environment and despite all best efforts you may cause injury to yourself and others. You also agree to take all precautions necessary to avoid this by following instructions and not attempting to practice anything that has been learned outside of the confines of this workshop? *

YES

NO

Would you like to hear about upcoming workshops? By clicking 'Yes' we will add you to our mailing list. *

YES

NO