Aikido of San Diego Registration Form

Name*

First NameLast Name

Date of Birth*

Date

Best Email Address*

example@example.com

Phone Number*

Please enter a valid phone number.

Do you have Aikido Experience?*

YesNo

If yes, briefly share how many years, current rank, and previous dojo

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, or any other communicable disease. 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 any communicable disease.*

Initial

Aikido of San Diego uses photos and/or videos taken at the dojo for traditional marketing, and possibly local news. We also post photos and videos on our social media, including Facebook, Instagram, and YouTube. Permission for your image to appear in our public media is appreciated.*

I give permission for my image to appear as stated aboveI DO NOT give permission for my image to appear as stated above

*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 AND INSTRUCTORS. I SIGN BELOW OF MY OWN FREE WILL*