Self-defense WorkshopPalos Verdes Estates, CA First name Last name Phone number Email Time slot 9 AM 10:30 AM Waiver By checking this box, you hereby acknowledge and agree to the Release of Liability as a participant of a Seniors Fight Back Seminar or Workshop. Assumption of Risk By checking this box, you and your party understand and accept assumption of risk in engaging in the activities contemplated in this voluntary event carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries, accidents, mistakes, errors or omissions. LADWP shall not be responsible for any liability which arises by reason of participation in this voluntary event and you agree to provide a complete and unconditional release of all liability to the greatest extent allowed by law in exchange for your participation in this voluntary event. Notice of Photography and/or Video Recording By checking this box to participate in this event, you are giving your consent to be photographed and/or video recorded. You are also waiving any and all claims regarding the use of your image for publication, exhibition, or reproduction by Los Angeles Department of Water and Power and its affiliates and representatives, and by Seniors Fight Back. Submit
