Name *

First Name

Last Name

Phone

(###)

###

####

Today's Date *

MM

DD

YYYY

Waiver *

By checking yes below and joining Idiot Workshop you declare that you are in good physical condition and have no disease or injury that would impair your ability to participate at Idiot Workshop; you consent to participate in class activities (including moving, jumping, warm-up, and physical acting); you fully accept and assume all responsibility for injury or damage that may result from your participation in Idiot Workshop and you release and hold harmless Idiot Workshop, its employees, teachers, including contracted teachers, and other participants with respect to any or all injury or damages arising from the activity to the fullest extent permitted by law.

Yes

COVID-19 Vaccination *

Have you been vaccinated for COVID-19 (2 weeks past your second shot or J&J single dose)?

YES

NO