Booking Form

Please complete this form if your child is a new student or if the contact and/or medical details have changed since you last completed the booking & waiver form.

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Only a parent or guardian over 18 may complete this form on behalf of the student to be enrolled in Hayes MMA.
Student's Name
DD/MM/YYYY
Parent / Guardian's Name
Please give the name and contact number of the person we should contact in the first instance
Please give the name and contact number of the person we should contact if we are unable to contact the first emergency contact.
Permission to receive First Aid as required
Permission to allow photographs and videos to be taken and used for marketing purposes
If none, enter N/A.

We understand this medical information is private, and as such will not be shared, presented or made public in any way other than to assist in the prevention of injury to your child. If you would prefer not to disclose any medical information, or feel you would rather discuss the matter privately, then please approach the lead instructor, Connor Hayes.
If none, enter N/A
DISCLAIMER: HAYES MMA (AND PARTICIPATING MEMBERS OF HAYES MMA) ARE NOT RESPONSIBLE FOR ANY INJURY (OR LOSS OF PROPERTY) TO ANY PERSON SUFFERED WHILE WATCHING OR PARTICIPATING IN ACTIVITIES HAYES MMA FOR ANY REASON WHATSOEVER, INCLUDING ORDINARY NEGLIGENCE ON THE PART OF THE MEMBERS OF HAYES MMA, INSTRUCTOR/COACH, MEMBER, VOLUNTEER, OR AGENT OF HAYES MMA OR ANY OTHER PARTICIPANT, VISITOR, OR PERSON PRESENT AT OR PARTICIPATING IN ACTIVITIES SUPPORTED BY HAYES MMA. In consideration of my child's participation, I hereby release HAYES MMA, instructor/coach, volunteers, or agents of HAYES MMA or any other MMA participant, visitor, or person present at or participating in activities supported by HAYES MMA, from any or all present and future claims resulting from ordinary negligence on the part of the HAYES MMA or others listed for property damage, or personal injury arising as a result of my child engaging in or receiving instruction in HAYES MMA sponsored activities or any activities incidental thereto, wherever, whenever, or however the same may occur. I hereby voluntarily wave any and all claims resulting from ordinary negligence, both present and future, that may be made by me, my family, estate, heirs, or assigns. Further, I am aware of the following risks, and NUMEROUS OTHER INHERENT RISKS of participating in Mixed Martial Arts sponsored by HAYES MMA. These risks include, but are not limited to serious injury resulting from: physical contact while participating in activities supported by HAYES MMA; including, but not exclusive to collision (with other persons or objects), being struck on the body or head, being thrown or dropped, suffocation resulting from choking or strangulation, dehydration, exertion, while participating in activities at HAYES MMA, ORDINARY NEGLIGENCE of the coaches, and members or volunteer assistants of HAYES MMA, those persons at the HAYES MMA who, lacking adequate training, seek to assist with medical or other help either before or after injuries have occurred. I understand that this waiver is intended to be as broad and inclusive as permitted by the laws of England and Wales, and agree that if any portion is held invalid, the remainder of the waiver will continue in full legal force and effect. I further agree that the venue for any legal proceedings shall be in England. I affirm that I am of legal age and freely sign this agreement. I have read this form and fully understand that by signing this form, I am giving up all legal rights and/or remedies which may be available for the ordinary negligence of the HAYES MMA or any of the parties listed above. By accepting this document, I acknowledge that I am voluntarily choosing my child to participate in physical exercise. In accepting this document, I acknowledge being informed of the strenuous nature of the activity and the potential for unusual, but possible, physiological results including but not limited to abnormal blood pressure, fainting, heart attack or even death. I also understand that my child may stop any training session at any time. By accepting this document, I assume all risk for my child's health and wellbeing and any resultant injury or mishap that may affect my child's wellbeing or health in any way and hold harmless of any responsibility, the instructor, facility or persons involved with the program and testing procedures.
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