Three Rivers Defense Trainee Questionnaire

Name

First Name

Last Name

Email address

Telephone number

Have you ever participated in any self-defense training? If so, what? When? Any martial arts training?

What are your expectations and goals for your training? Are there any particular safety or physical defense issues that you would like us to address? Are you looking primarily for physical training or are you also interested in personal safety / violence dynamics training?

Have you ever been the target of any physical or other violence? If so, please describe if you feel comfortable doing so.

Do you have any concerns or questions regarding the training?

Training and Safety Agreement

Name

First Name

Last Name

Email Address

TRAINING SAFETY AGREEMENT1. Report any injury, discomfort, or other wellness issues to your instructor immediately. If something doesn’t feel right, report it. 2. Don’t overexert yourself. We do not compete with each other. 3. Make eye contact with your instructors during wellness checks. 4. Ask questions at any time when something is unclear to you. 5. Do not engage in horseplay or unauthorized physical contact. 6. If you notice anything that you feel is unsafe, report it. 7. Do not wear jewelry, watches, or protruding body art during training. 8. Keep training area free of shoes, clothes, and gym bags. 9. Do not handle any training equipment without your instructors’ permission and only under their supervision. 10. Stop action immediately when your instructor or the timer uses the whistle, or clapper, or gives a ”Stop” or “Time ” instruction. 11. Use force as instructed by your instructor. Do not use more. 12. Use good control and focus and use force and speed in partner training as instructed. 13. Support and encourage your training partners. 14. Train safely at all times. Any questions? Please let us know below.

By submitting this form, I acknowledge that I have read this Training Safety Agreement and agree to abide by it. Any questions are listed below.