Upcoming Tai Chi Course payment

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Upcoming Tai Chi Course payment

Tai Chi Course – 8 week in person

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Course Date

Course Start Date – 12/10/2025

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State Post Code

Email(Required)

Phone(Required)

Date of birth(Required)

Age(Required)

Please note that you have entered an age outside of the participation ages of 6 years to 99 years. If this is correct then I wish to advise that you are not eligible to participate in this course.

I, the abovenamed understand that Tai Chi is a form of gentle exercise. I confirm that I have either obtained a medical clearance or otherwise confirm that I am medically fit to safely participate in this Tai Chi Course.
By participating in this Tai Chi Course and by signing this document I agree to the below statements:

(i) I agree that I shall not bring any claim, suit, action or proceeding whether at law or in equity or under any statute against you and/or any person conducting the Tai Chi Course in your absence in relation to personal injury as a result of my participation in The Tai Chi Course

(ii) I agree that this Waiver may be pleaded as a complete bar to any such claim, demand, suit, action or proceeding sought to be commenced or maintained by me in relation to any injury or loss incurred by me during or as a result of my participation in the Tai Chi Course;

(iii) I accept that the instructor may refuse my participation in the Tai Chi Course for reasons related to health, safety and well-being for all participants.

I confirm that I agree with the above waiver(Required)

Parent/Guardian Signature (If under 18)(Required)

Please note that children under the age of 13 must have an adult present for the duration of the course

As part of undertaking this course, I consent to the use of any photographs or videos taken of me, as well as any feedback or written comments by me in connection with my participation in the Tai Chi Course. This may be used for publicity, promotion, demonstration or other business purposes, on any medium including the internet. I waive any right to compensation in connection with such use. If I do not want images of me used, I will notify Black Crane Kung Fu in writing (e-mail).

I consent to the use of photos and confirm I am over 18(Required)

Yes

I consent to the use of photos of my child(Required)

Yes

Guardian's Signature if under 18 (Consent for Photo's and Video's)(Required)

Read our policies here

Confirmation that policies have been read(Required)

I confirm that I have read and understood all the policies as an Adult or Guardian

Tai Chi Course – 8 week in person(Required)

Price:

If you would like to purchase more than one ticket, each person will need to do a sign up form so that each person may sign the waiver section.

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Coupon

If you have been given a coupon code. Enter it in here.

Credit Card

Card Details

Cardholder Name

Total