Skip to form

City of Greenfield

contact@greenfieldwi.us

7325 W. Forest Home Ave., Greenfield , WI, 53220, US

Full Name

Date of Birth

Full Address

A portion of this seminar has a physical self-defense component that the person attending MAY participate in.  Participation is NOT mandatory and the attendees can work at their own pace.

Do you have medical conditions that the instructors need to be aware of?

Have you had any martial arts or self-defense training?

Emergency Contact

Emergency Contact

WAIVER: I hearby acknowledge that I will be participating in a seminar which may include participation in physical activities.  By signing this application, I hereby release the City of Greenfield Police Department and their employees, agents and/or designees, from any and all liability for any injuries that I may sustain as a result of my participation in this seminar.

Sign Here

Choose how to sign