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Before submitting forms, please contact the office to check availability. Submitting forms does not guarantee enrollment.
Child Liability Form
Adult Liability Form
Veterans/Active-Duty
Additional Forms
SUBMITTING REQUIRED FORMS DOES NOT GUARANTEE A SPACE IN CLASS
CONTACT THE OFFICE AT (559) 432-6292 TO CHECK ON AVAILABILITY
Liability Waivers
These forms can be submitted online, printed, or completed in person at our facility.
For students under 18 years of age, a parent or Legal Guardian must complete a Child Liability Waiver.
Adult students & adults assisting a student must complete an Adult Liability Waiver.
In addition to a liability waiver, all students enrolling in the Aquatics program must complete the Aquatics registration and waiver before starting class. This form must be completed when signing up for each new session of swim classes.
Sometimes a doctor’s release is required to participate if a student has specific physical or medical conditions such as (but not limited to) heart conditions, epilepsy, or bone and joint issues. Please contact us if you have questions about specific medical conditions.
There are three different releases we use:
In addition to a liability waiver, all HOPE clients must complete “A Hope Release & Policy” form and return it to Break the Barriers’ front office in order to participate:
If you are a Veteran and interested in taking free classes at Break the Barriers, please print and complete this registration packet. For VA Medical Release form, please go your to Primary Care Physician at VA and request a Recreation Therapy Consult from either Andrea Hernandez or Antonio Cuyler. At consultation ask to participate at Break the Barriers. *If you are not going through VA, have your personal Primary Care Physician sign the VA Medical Release form.