UCA Lua de Prata
Batizado & Formatura 2024
May 9th to 12th

 
 
 

UCA
Mestre Acordeon - Mestre Rã - Mestra Suelly
Mestre Mata Mosquito

 
 
 
 
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Contact Information
e-Mail:
First Name:
Last Name:
Apelido (Nickname):
Street Address:
City:
State:
Zip Code:
Country:
Phone
T-shirt Size
 
Emergency Contact Info
Emergency Contact:
Phone:
Relationship
Emergency Comments:
 
Capoeira Information
Group Name:
Capoeira Teacher:
Years Training
Cordão:
 
Housing (Please fill up if you need housing only)
Arriving Date:
Departure Date:
Special Accomodations:
   
General Comments:
Waiver

I hereby acknowledge that I wish to participate in the UCA Lua de Prara Batizado & Formatura at the Wildcat Studio. I understand that instruction in martial arts, fitness classes, and related activities involve strenuous exercise and can result in personal body contact and/or injury. As a condition to being admitted as a participant to the event, I assume the risk of all injury to myself and to my personal belongings; I agree to hold the Wildcat Studio, it's owners, it's tenants, its employees, and agents harmless from any and all liability (including attorney’s fees and costs) for all claims, actions or damages due to injuries suffered by me or caused to someone else by me, arising out of the activities that I participate in, whether occurring at the 2525 8th #15n Berkeley, CA facilities or elsewhere during workshops, performances, and gatherings. I hereby assume all risks connected therewith and consent to participate in this event. I also understand and agree that the strict observance of the UCA CODE OF CONDUCT shall be adhered to at all times.

I HAVE READ THIS LIABILITY WAIVER, RELEASE, AND INDEMNIFICATION AGREEMENT, AND FULLY UNDERSTANDS ITS TERMS. I understand that by entering into this agreement, I am giving up substantial rights, including the right to sue. This Waiver and Assumption of Risk does not apply to claims, actions, or damages caused by the gross negligence or intentional act or omission of UCA Lua de Prata.
I agree to my image being captured, whether on film, video, or by photograph, during the course of the event. I declare that the info I’ve provided is accurate & complete

         I have read the above release and agree enterely with its terms.

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For comments or questions please contact us at info@ucaluadeprata.com
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