Please fill out the form and click Send to register. Once you click on the Send button you will be able to choose your payment option and then pay securely through PayPal. If you are eligible for a discount, please contact Mestra Luar do Sertão. Mestres, Contra Mestres, and Professores, we invite you to bring your great energy. Please fill out the form and send only this 1st form so that we can confirm your attendance! Participant 1 Name (Last, First) (Required) Apelido Age (Minors Only) Previous Months/Years or Belt in Capoeira (Required) Training Location T-Shirt Size (required) —Please choose an option—Child SChild MChild LAdult SAdult MAdult LAdult XLAdult XXL Pant Size (CMT Participants ONLY) —Please choose an option—Child 8Child 10Child 12Child 14Child 16Adult SAdult MAdult LAdult XLAdult XXL Participant 2 Name (Last, First) Apelido Age (Minors Only) Previous Months/Years or Belt in Capoeira Training Location T-Shirt Size —Please choose an option—Child SChild MChild LAdult SAdult MAdult LAdult XLAdult XXL Pant Size (CMT Participants ONLY) —Please choose an option—Child 8Child 10Child 12Child 14Child 16Adult SAdult MAdult LAdult XLAdult XXL Address (required) Email (required) Phone Number (required) Emergency Contact Name (required) Emergency Contact Phone Number (required) ASSUMPTIONS OF RISK AND PERSONAL RESPONSIBILITY I/We, the participant/participants named above, desiring to participate with the above named organization, do so at my/our own risk, realizing athletic participation in general can increase the risk of injury and that capoeira in particular has its own unique risk factors. By permitting me/us to participate in classes, workshops, performances and/or related programs or events, Capoeira Mandinga Tucson does not assume responsibility for any risks, injuries or damages incurred by me/us as a result of participating. I fully understand that I/we shall bear full responsibility for the consequences of my/our own actions. I knowingly, voluntarily, and expressly waive any claim I/we may have against Capoeira Mandinga Tucson for injury or damages that I/we may sustain as a result of participating in the program. I/We represent and warrant that I/we am/are physically fit and I/we have no medical condition that would prevent my/our participation in the classes, workshops, performances, or events. I/We understand and agree: • To follow instructions and act respectfully towards instructors and other students. (Parents are expected to help implement this rule with their participating children.) • Tuition fees are non-refundable. • To pay in full the tuition for the respective classes. • Capoeira Mandinga Tucson is not responsible for money or items lost or stolen, damaged or left behind in the studio or performance sites. • Capoeira Mandinga Tucson may use video and/or photographs taken during class, workshops or performances for publicity and/or advertising purposes. Name of Parent/Guardian if any Participants are Under 18 Years of Age By submitting this form you are agreeing that the person submitting the form is 18 years of age or older and has read and agrees to the above Assumption of Risks and Personal Responsibility for all participants listed on this form. If you need housing please email Tarantula (Abby Limmer) at alimmer@email.arizona.edu. We look forward to seeing you at our Batizado 2016 event!
