305-330-5200


REGISTRATION FORMS FOR: 


EDUCATIONAL,

FITNESS, 

&/OR

NUTRITIONAL PROGRAMS



CONFIDENCE. SELF-ESTEEM. SUCCESS.

30 MINUTES FREE TUTORING

REGISTRATION FORM

We are excited you are joining our team. Please complete the following information. 

It includes your Demographics, Financial Responsibility, and our Hold Harmless Release. See you soon. 

If there is more than one parent or legal guardian, please enter both names.
Client's Gender:
May we contact you via text:
If client is a minor, enter for parent/legal guardian
What I wish to accomplish:
Check all that apply.
If emergency medical care is necessary, do you grant permission for emergency medical treatment?*
Full Name, Relationship, Address and Phone Number.
Family, Friend, Social Media, Internet Search, Etc.
Financial Agreement:*
The undersigned promises to pay financial obligations prior to participating.
By signing electronically and submitting below I declare that all of my responses are accurate and true to the best of my knowledge; and that I have read, understand and agree to abide by the terms of the Code of Conduct, Suspension/Expulsion policy, and Financial Agreement. In addition, I hereby waive, release, absolve, indemnify, and agree to hold harmless Circle of Life Coaching, Inc., (COL) its directors, officers, organizers, sponsors, supervisory staff, participants, and any other affiliates; for, from, and against all liability because of any bodily injury, or property damage, known or unknown, which may occur or result from the participation of myself and/or of my child in any and all activities whether the result of negligence or for any other cause of COL. I individually, and/or as a parent/guardian for my child, have read this release and understand all the terms. I execute it voluntarily and with full knowledge of its significance.
SUBMIT
Thank you! Your forms were sent successfully.

           CODE OF CONDUCT:              SUSPENSION/EXPULSION POLICY:

CODE OF CONDUCT:

Respect yourself, others and the staff and its property.

Maintain good hygiene.

Always play and train safely.

Do not disturb others while training.

Avoid inappropriate language.

Tobacco, drugs, alcohol, and weapons of any kind are prohibited. 

SUSPENSION/EXPULSION POLICY:

Physical assaults or threats.

Harassment, name-calling, racial slurs, foul language or taunting.  

Intimidation or spreading rumors.

Sexual harassment – physical or verbal.

Using the internet to harass, threaten, verbally abuse, intimidate, or spread rumors.

If found to be in violation of this policy, student may be suspended or expelled, with no refunds. 

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