Class Registration | Smart Girl Self Defense
Distance, Time, Safety Class
We’re glad you’re here. This short application registers you for a Smart Girl Self Defense class and confirms you’re ready to train.
Who Can Attend
Smart Girl Self Defense classes are open to participants who meet all of the following:
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Must be a biological female
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Must be 12 years old or older
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If under 18, must have the consent of a parent or guardian
New Student Special
Your first Smart Girl Self Defense class is the start of something lasting. After you complete your first class, you can attend refresher classes for free whenever there is space available at the time you register.
As part of the New Student Special, you will also receive a Smart Girl Self Defense bandanna.
Referred Student
New Student Referred by a Smart Girl
Were you invited by someone who has already trained with us? Select this option so we can welcome you and recognize the Smart Girl who referred you.
Smart Girl Refresher Class
Already completed your first class? Register here for a refresher. Refresher classes are free for past participants as long as space is available when you register.
Register for a Distance, Time, Safety Class
Chose your registration type at the date of the class you want to attend.
<<CMS#>> are students registered for the
<<CMS DATE>> class.
Registration last updated <<CMS DATE>> at <<CMS TIME>>
Referral Code:
Refering Smart Girl:
Click Next to continue with your regestration.
Class Registration | Smart Girl Self Defense
Student Information
Please complete the information for the student.
All fields except Limitations are required. Limitations are optional — use them to let us know about any injuries, medical notes, or anything else we should be aware of so we can train safely.
When you’re finished, click Next to continue.
Student
Information
⬅️ Select Date Of Birth
Class Registration | Smart Girl Self Defense
Primary Contact
Who should we contact first? Enter the primary contact for this student We’ll use this person for important updates, scheduling, and school communications.
Additional Contacts (Optional)
Anyone else we should know about? Add emergency contacts or additional parents and guardians.
Address
Please enter the address for the student so we can keep our records complete.
Click Next to continue with your application.
Class Registration | Smart Girl Self Defense
Almost Done
Please review and accept the terms of Participation Agreement & Acknowledgment to continue.
Smart Girl Self Defense
Participation Agreement & Acknowledgment
Smart Girl Self Defense, the American Institute of Kenpo (AIK), Jackson Wink, all instructors, and associates are referred to in this agreement as the Presenters.
Waiver and Release of Liability, Assumption of Risk, and Indemnity
In consideration of acceptance as a participant in any Smart Girl Self Defense class, including the Distance, Time, Safety class, I do hereby, for myself, my heirs, executors, and administrators, waive, release, discharge, covenant not to sue, and agree to indemnify, save, and hold harmless the Presenters, other class participants, and the owners and lessors of the premises on which any Smart Girl Self Defense class is held, from any and all claims for damages which I may have or which may accrue to me, in connection with my participation in any Smart Girl Self Defense class, athletic event, seminar, training, or related activity, including travel to and from such activities.
I understand the nature of these activities and believe that my experience, health, and capabilities qualify me to participate. I understand that participation in any sport, athletic event, training, class, or seminar involves inherent risks, including the risk of bodily injury, permanent disability, paralysis, and death. These risks may be caused by my own actions or inactions, or by the actions or inactions of others. I acknowledge that it is recommended that I consult a doctor before beginning any form of exercise.
I hereby knowingly and voluntarily assume all such risks as a condition of being allowed to participate. I understand, intend, and will waive and release these claims even if they arise wholly or in part out of the negligence or intentional actions of the Presenters, their members, employees, or agents.
COVID-19 Acknowledgment
I understand and acknowledge the contagious nature of COVID-19 and other communicable illnesses, and I voluntarily assume the risk that I may be exposed or infected by visiting the Presenters’ facilities or participating in any class or event. Such exposure or infection may result in personal injury, illness, permanent disability, or death. I release, covenant not to sue, discharge, and hold harmless the Presenters and their agents, owners, representatives, and employees from any and all liabilities, claims, suits, actions, losses, damages, costs, or expenses of any kind arising from such exposure or infection, whether it occurs before, during, or after my visit or participation.
Public Image Consent
I consent to any pictures, video, or other likeness taken of me in connection with the Presenters for publicity, promotion, website, social media (including Facebook and Instagram), television, or other public use. I understand that other participants or visitors may also capture images or video during classes or events, and that the Presenters are not responsible for images shared by third parties. I hereby waive any claim for compensation or liability arising out of such use.
Refund and Rescheduling Policy
I understand that if I am unable to attend a Smart Girl Self Defense class for which I am registered, it is my responsibility to notify AIK at least 24 hours prior to the class. If I fail to provide timely notice, I will not be eligible for a refund.
Class Canceled for Low Enrollment: If AIK cancels a class because there are not enough participants, I may request a full refund with no refund fee, or have my payment credited to the next Smart Girl class.
Participant-Requested Refund: If I request a refund for any other reason and provide at least 24 hours’ notice, I agree to a $10.00 refund fee that will be deducted from the class registration fee. All refunds will be issued by check, and it is my responsibility to pick up that check within 30 days of the class. If I fail to pick up the check within 30 days, I release AIK of all financial responsibility to issue the refund.
Instead of requesting a refund, I may attend a future Smart Girl Self Defense (Distance, Time, Safety) class, subject to available space. It is my responsibility to register for a future class while space is available.
Consent
I have read this agreement, fully understand its terms, understand that I have given up substantial rights by agreeing to it, and have done so freely and without inducement or assurance of any nature. I intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law. If any portion of this agreement is held to be invalid, the balance shall continue in full force and effect.
If the participant is under 18, this agreement must be acknowledged by a parent or guardian.
Class Registration | Smart Girl Self Defense
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