FABULOUS FIT & FIERCE (F3)
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Black Belt Instructor
A little More About Me
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Basic/ Intro class
Fitness Self Defense Class Components
Foundational Women's Brazilian Jujitsu
Locations
Main: Samuel Puccio Brazilian Jiu-Jitsu
More Fire Crossfit
Contact
Message/ Review
What Type of Classes would you like to see added?
Main Website: ANESTEA SERVICES LLC: WHOLESTIC LIFESTYLE COACHING-CONSULTING
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If you answered Yes to the Above you must provided a Parent/ Guardian name.
By typing Parent/Guardian First and Last name here you acknowledge that You have permission to attend our programs. You also Agree that Said formentioned person agrees to be present at first class, session, event etc.
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Samuel Puccio BJJ
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Waiver Release: I hereby consent to participate in activities offered by Anestea Services and or Angela L. Carmichael Smith. It is hereby agreed that I and/or my children waive and release all right and claims for damages that I and/or my children may have at any time against Anestea Services or Angela L. Carmichael Smigh, and/or any associated representatives whether paid or volunteer; for any injury of damages in connection with any and all programs or other activities related to the programs offered. The risks involved in respect to such a program are fully understood.
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Permission for Medical Treatment: I confirm that the previously named person is in good health unless indicated below. I hereby authorize simple first aid.
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CONSENT FOR PRODUCTION AND USE OF VERBAL OR WRITTEN STATEMENTS, PHOTOGRAPHS, DIGITAL IMAGES, AND/OR VIDEO OR AUDIO RECORDINGS BY Angela L. C. Smith or Anestea Services NOTE: The execution of this form does not authorize production or use of materials except as specified below. The photograph, digital image, and/or video or audio recording will be produced while I am Participating in Activities with or related to Angela L. C. Smith and/ or Anestea Services. The specified material may be produced and used by Angela L. C. Smith and/or Anestea Services for authorized purposes such as education, research activities, or promotional efforts. It may also be disclosed as permitted by law. The purpose of this form is to document your consent to Angela L. C. Smith and/ or Anestea Services request to obtain, produce, and/or use a verbal or written statement or a photograph, digital image, and/or video or audio recording containing your likeness or voice.
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By signing this form, you are authorizing the production or use. You may rescind your consent at any time prior to or during production of a photograph, digital image, or video or audio recording, or before or during your provision of a verbal or written statement. You may rescind your consent after production is complete if the burden with that request is not unreasonable considering the financial and administrative costs, the ease of compliance that number of parties involved.
By typing you First and Last name here you acknowledge that all the information given in correct to the best of your knowledge and you agree to the waver conditions as indicated. Electronic Signiture (First and Last name Please)
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Home
Main Instructor & Coach
>
Black Belt Instructor
A little More About Me
Why choose us?
Why an on-going class sessions
Calendar (General Sessions, Extra Training Sessions)
Start Here*
Registration/ Waver
Booking Page (Anestea Services LLC)
Sessions Options ($)
General Open Sessions & Payment Page
Private Sessions & Payment Page
You and Your Friends: Group session/ & Payment Page
About
Basic/ Intro class
Fitness Self Defense Class Components
Foundational Women's Brazilian Jujitsu
Locations
Main: Samuel Puccio Brazilian Jiu-Jitsu
More Fire Crossfit
Contact
Message/ Review
What Type of Classes would you like to see added?
Main Website: ANESTEA SERVICES LLC: WHOLESTIC LIFESTYLE COACHING-CONSULTING