EBA Registration

Step 1: Age Verification

You must be 18 or older to complete this registration. Please enter your date of birth.

Your Date of Birth (dd/mm/yyyy) *

Example: 25/12/1990

I confirm that I am 18 years or older and responsible for these registrations.

Step 2: About You

Full Name *

Email Address *

Phone Number *

Gender *

Male Female Prefer not to say

Area / Town *

Occupation / Place of work

Are you a student? *

Yes No

Where do you study? *

Are you a new or current EBA member? *

New member Current member

Step 3: Contact & Consent

Emergency Contact

Emergency Contact Name *

Emergency Contact Phone *

Relationship to You *

A Few More Details

How did you hear about us? *

Primary goal / reason for joining *

How Can We Reach You?

Preferred contact method (select all that apply) *

WhatsApp Email SMS/Text Phone call

I'd like to receive class updates, offers, and news from EBA.

Photo / media release *

EBA occasionally posts class photos and videos on social media.

I consent I do not consent

Step 4: Health & Services

Choose the services you're interested in and complete a short PAR-Q health screening. Answering "Yes" doesn't stop registration — our team will simply check in with you first.

Register your children

Authorized pick-up / second guardian

Someone (besides you) allowed to pick up or be contacted about your child(ren).

Name *

Phone *

Relationship *

Step 5: Liability Release & Waiver

ASSUMPTION OF RISK, LIABILITY WAIVER & RELEASE OF LIABILITY

In consideration of being permitted to participate in activities at Edson Breedy Athletics (EBA), I acknowledge, agree, and represent the following on behalf of myself and any children I am registering:

1. Assumption of Risk

I understand that martial arts, boxing, fitness, therapy and related physical activities involve inherent risks of injury, including serious injury, and I voluntarily assume all such risks.

2. Release of Liability

I release, waive and discharge EBA, its owners, coaches, therapists, staff and volunteers from any and all liability, claims or demands for injury, death, or property damage arising from participation, whether caused by negligence or otherwise, to the fullest extent permitted by law.

3. Medical Fitness

I certify that each participant is physically able to participate, and I have disclosed all relevant medical conditions via the PAR-Q health screening and any health intake.

4. Emergency Care

I authorize EBA staff to arrange emergency medical care if needed, and I accept responsibility for any resulting costs.

5. Property & Conduct

I agree to follow all facility rules and instructor directions, and I am responsible for any damage I or my children cause to EBA property.

6. Acknowledgment

I have read this waiver carefully and understand that by agreeing I am giving up substantial legal rights, including the right to sue.

I have read and agree to the Liability Release & Waiver on behalf of myself and the children I am registering.

Step 6: Review & Submit

I confirm all information is accurate and I agree to submit this registration.