Guard Up and The Story School
Notice of Risk and Media Agreement

This online Risk and Media Agreement is used for those attending our public and private events as well as for birthday party attendees.  You MUST be 18 years or older to sign/submit this form. Attendees under the age of 18 must have their parent or legal guardian sign/submit this form.

 Directions:  Under the "Birthday Party OR Event Title" field, please input the title of the birthday party or the title of event or class you are attending. Under the Birthday Party Host Name or Event Type, please input the first and last name of your host's name (i.e. the birthday boy or girl's name) or the type of event you are attending (Sword, NERF, D&D, Open House, Fencing Class, etc).


calendar calendar

calendar calendar
Is this an overnight event? *
Does the student/camper have an allergy to latex? *
Would you like to register and purchase an event now? *
I am interested in a free foam sword, NERF, or foil fencing trial membership for my child or myself: *
 *
 Emergency Contact Information
Name:
Relationship:
Number:

Behavioral Accomodations

Does your child require special accommodations or behavior? IE: Are they easily frightened by masks?  Do they get upset easily if rules are broken?  Do they get over-stimulated in physical activities?  Have they hit things in anger? *

Dress Code

All participants must wear long pants and shoes that cover both the toes and the heels. *

Overnight Events

For our events where students stay the night we require a bit more information. Please fill out the following fields so that we can accommodate them for the night.
 *
 Emergency Contact Information
Second Contact Name:
Second Contact Relationship:
Second Contact Home phone:
Second Contact Cell Phone:
Does your child have an Epi-Pen? *
Please note that we will not be administering any medications to attendees. If your child has any evening medication it must be administered before arriving to the event. Epipens and other emergency medication may be carried by the attendee.
Please select sleeping arrangememts for your child *
Registration *
For Credit Card:

Please read the following before signing below

For Credit Card:
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary. *
Please sign your full name with your mouse: *
clear
Guard Up! Family Swordsmanship     103 Terrace Hall Ave., Burlington, MA     (781) 270-4800