Nagare Aiki Dojo Registration & Liability Waiver Form Logo
  • Nagare Aiki Dojo

    Registration Form and Liability Waiver
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  • TERMS AND CONDITIONS

    STATEMENT OF INTENT

    I herby state my intent to enroll myself and/or my child/ren in the training program offered by Nagare Aiki Dojo. I herby agree to abide by all the rules, regulations, code of personal conduct, customs and ceremonies as set forth by Nagare Aiki Dojo

    ACKNOWLEDGMENT OF GOOD HEALTH

    I certify that I am in good health and that I know of no impairment to my health that would prevent me from taking the courses and training provided by Nagare Aiki Dojo. I fully understand that martial arts training requires strenuous physical activity including physical contact. I fully understand that martial art is a combat sport and I am aware of the risks involved in training in a combat sport. I agree to assume the risk of any adverse effect on my health due to participation in martial arts training, demonstrations, and all activities. I further agree to assume the risk of personal injury resulting from participation in the courses and training provided by Nagare Aiki Dojo

    WAIVER OF LIABILITY

    In consideration of the privilege of participating in the activities of the Nagare Aiki Dojo, I agree to assume all risk of personal injury while attending or participating in any activity conducted by or connected with the Nagare Aiki Dojo, Noah Levine, Louise Rafkin, Inc., or DBA Studio Naga. I fully understand that martial arts training and activities involve physical activities which could result in personal injury. I hereby waive any potential claim against the Nagare Aiki Dojo, Noah Levine, Louise Rafkin, Inc., or DBA Studio Naga which could result from participation in martial arts training and activities. I further agree to waive any such claim against anyone connected or associated with the Nagare Aiki Dojo, Noah Levine, Louise Rafkin, Inc., or DBA Studio Naga.

    WAIVER/RELEASE FOR COMMUNICABLE DISEASES INCLUDING COVID-19

    ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT

    In consideration of being allowed to participate on behalf of Nagare Aiki Dojo  athletic program and related events and activities, the undersigned acknowledges, appreciates, and agrees that:

    Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,
    I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
    I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,
    I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Nagare Aiki Dojo their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
    I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

    FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)

    This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.

     NO REFUND POLICY

    1. Nagare Aiki Dojo has a strict no refund policy. Please sign up for the duration of the program you are willing to commit to as Nagare Aiki Dojo does not give refunds for any reason.

    2. If a student displays poor attitude, unacceptable and distracting behavior, behavior that affects the class and/or training sessions; student may be transferred to a private lesson program.

    3. As the Nagare Aiki Dojo athlete and as ambassadors of the Nagare Aiki Dojo Program and the sport of martial arts, Nagare Aiki Dojo athletes and members are held to a high standard by the Nagare Aiki Dojo, the community and the public. Responsible conduct advances the interest of the sport of martial arts, members, and the program. Conversely, irresponsible conduct by a member tarnishes the reputation of the both affected member and the Nagare Aiki Dojo and undermines the positive image set by other members and athletes of the program. Discipline may be imposed for misconduct, which includes without limitation, the following examples: a. Conduct that undermines or puts at risk the integrity and reputation of the MMA b. Derogatory or offensive conduct, including without limitation insulting language, symbols, or actions about a person’s ethnic background, heritage, color, race, national origin, age, religion, disability, gender or sexual orientation; c. Inappropriate physical, verbal, and online behaviors (such as inappropriate statements made); d. Conduct that undermines or puts at risk the Nagare Aiki Dojo or promotion of an Nagare Aiki Dojo event

    4. Nagare Aiki Dojo extension policy:  

    Membership Extensions:

    a. Must submit an “Extension Request”  for approval prior to going on break or immediately returning from break. NOTE: You will not be eligible for a membership extension if you fail to submit an extension request form prior to going on break and/or on the day of the first class upon return from break.

    b. The break must be longer than 10 days to be eligible for a membership extension 

  • THINGS TO KNOW: 

    There are no hidden costs. Below is a list of additional investments that you will come across on your Martial Arts Journey towards Black Belt and/or during your participation in the Nagare Aiki Dojo program.

    TESTING FEES are a separate investment from the monthly tuition.

    There are testing fees to cover the expense of the belt promotion that includes student’s new belt, testing materials, Aikido certificate, and registration expenses. The testing fee starts from $50 and increase as the student promote to higher level classes and training. Fees are subject to change depending on improvements of the testing procedures and our organization’s affiliations.

    WEAPONS and UNIFORMS are a seperate investment. 

    The student will need to purchase a uniform (gi) and weapons set, Bokken (wooden sword) and Jo (wooden staff). 

    REQUIRED SEMINARS. Pricing is available upon request. These programs are provided for the benefit of our students to learn leadership skills, gain more knowledge about the Aikido philosophy, and stay up to date on the most current training forms and practices.

    Other optional additional investments:

    One-on-One Training, Add-on Training Programs, Etc.

  • PICTURES, IMAGES, VIDEO CLIPS and/or FILMS CONSENT

    By participating in the Nagare Aiki Dojo classes, promotion tests, events, competitions, and other affiliated events, I understand that me, and/or my minor child, and/or my family might be photographed or filmed.

    I hereby grant permission to Nagare Aiki Dojo and its affiliates and subsidiaries to interview, photograph, and/or videotape me and/or my minor child; and/or to use and permit to use, print, and publish without payment and compensation for any purpose whatsoever including advertising, publicity, and internet purposes. The Picture, Images, Video Clips and/or Films may appear in color or black and white, may be distorted, blurred, or altered. I waive any right to inspect or approve the Pictures, Images, Video Clips and/or Films or any written copy that may be used in connection with the Pictures, Images, Video Clips and/or Films.

    I release, hold harmless and waive any claims against Nagare Aiki Dojo related to Pictures, Images, Video Clips and/or Films or the exercise of the rights granted herein, including claims for compensation, claims of defamation or any claims regarding rights of privacy or publicity.

    This release shall also be applicable to Nagare Aiki Dojo’s officers, directors, employees and agents, including without limitation the photographer and any advertising agency who may be involved in creating and disseminating the Pictures, and any newspaper, magazine or other publication in which the Pictures, Images, Video Clips and/or Films may appear.

    I also understand that publication of the Pictures, Images, Video Clips and/or Films is within the sole discretion of Nagare Aiki Dojo and that they may not be used at all.

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