This offer is valid for first time Capoeira Mandinga students only.

Where did you hear about this class/workshop? (required)

Name (Last, First) (required)

Age (minors only)

Address (required)

Email (required)

Phone Number (required)

Emergency Contact Name (required)

Emergency Contact Phone Number (required)

Previous Months/Years or Belt in Capoeira (required)

Capoeira Nickname (if previously trained)

ASSUMPTIONS OF RISK AND PERSONAL RESPONSIBILITY

I, First and Last Name (required), desiring to participate with the above named organization, do so at my 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 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 as a result of participating. I fully understand that I shall bear full responsibility for the consequences of my own actions. I knowingly, voluntarily, and expressly waive any claim I may have against Capoeira Mandinga Tucson for injury or damages that I may sustain as a result of participating in the program. I represent and warrant that I am physically fit and I have no medical condition that would prevent my participation in the classes, workshops, performances, or events.

I 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.

Choose a start date for your two week trial to begin. Two week unlimited pass is good for two weeks after your chosen start date.

Start Date