Aikido of San Diego Registration Form
Must be completed by anyone training with us, or on behalf of a minor.
Student's Name
*
First Name
Last Name
Parent/Guardian's Name (if student is under 18)
First Name
Last Name
Best Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student's Date of Birth
-
Month
-
Day
Year
Date
Occupation
Do you have Aikido Experience?
*
Yes
No
If so, how much? Any rank? Where did you train?
RELEASE, CONSENT, AND ASSUMPTION OF RISK
I am aware that Aikido involves strenuous physical activity and personal body contact, and that I will be participating in martial arts training which can be physically harmful and/or emotionally stressful.
*
Initial
I am voluntarily participating in Aikido training with full knowledge of the danger involved. I agree to assume any and all risks of injury, illness, or death, caused by negligence of Aikido of San Diego, its owner, directors and instructors or any other agents.
*
Initial
If I have a disability, illness, pregnancy, or am currently seeing a therapist, I promise to consult with my physician or therapist before participating in Aikido.
*
Initial
I agree that I, my heirs, legal representatives and assigns will not make a claim against Aikido of San Diego, its owner, director and instructors or any other agents for any injury or damage, or loss resulting from my participation in Aikido training or sustained on the Aikido premises, whether participating in Aikido training or not.
*
Initial
I release and discharge Aikido of San Diego, its owner, directors and instructors or any other agents from all claims or demands arising from injury, damage, or loss to me caused by my participation in Aikido training or sustained on the Aikido premises, whether participating in Aikido training or not.
Initial
I agree to assume any and all risks of injury, illness, death, or personal property loss/theft/damage, caused by negligence of Aikido of San Diego, its owner, directors and instructors or any other agents, sustained on the Aikido premises, whether participating in Aikido training or not.
*
Initial
I agree to abide by all Aikido of San Diego and municipal health precautions and procedures related to COVID-19. I agree to release and hold harmless Aikido of San Diego, its owner, directors and instructors, or any other agents, from the risks of potential exposure to COVID-19, or any other communicable disease.
*
Initial
*FOR PARENTS OF MINORS* We the parents or legal guardian(s), consent to allow this minor individual to participate in Aikido training at Aikido of San Diego. We have read, understood, and initialed each of the paragraphs of the Release, Consent and Assumption of Risk statement and intend to bind ourselves, the minor, and all heirs, successors, executors, the estate, and dependents of said minor, to the terms hereof. We agree to hold the owner, directors, instructors, and all individuals associated with Aikido of San Diego from any action brought as a result of participation by this minor in any activity of Aikido of San Diego, and promise to indemnify Aikido of San Diego, and all releases for all liability and losses including attorney’s fees occasioned by a claim by, on behalf of, or on account of injuries or illness to said minor, and to fully indemnify all such losses.
Initial
I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND AIKIDO OF SAN DIEGO, ITS OWNER, DIRECTORS AND INSTRUCTORS. I SIGN BELOW OF MY OWN FREE WILL
*
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