do hereby make application to participate in Martial Arts instruction at Phoenix Karate Inc.
I fully understand, acknowledge and agree that in order for my application to be considered and to be able to participate in the programme, I must be physically able to do so. Therefore, I do hereby state that I am in good physical health and do further acknowledge and agree that Phoenix Karate Inc, its proprietors and instructors are relying upon my statement to this effect in allowing my application.
I Do FURTHER UNDERSTAND AND AGREE that for valuable consideration the receipt and sufficiency of which is hereby irrevocably acknowledged Phoenix Karate Inc, its proprietors, instructors, agents, employees, servants, successors, assigns, landlord and the landlord of the property as well as their servants, employees, agents, successors and assigns ("the Releasees") will not be held responsible for any accident, loss, injury or damage however caused and agree that by signing this form, I do hereby waive, indemnify, remise, release and forever discharge the Releasees from and of any and all liability for any loss, claims, demands or damages, including, but not limited to, that arising from personal injury or death sustained through my receiving instruction, taking part in the programme or doing any physical activity associated with martial arts or the use of the said facilities or equipment or in any way resulting from my participation in the programme or my attendance at the property and this Release and Acknowledgement shall be binding upon my family, heirs, successors and assigns.
In the event of inability to contact the Parent or Guardian of a minor or to obtain my written consent for any reason whatsoever, the undersigned hereby gives Phoenix Karate Inc, its proprietors, instructors, employees, servants or agents permission to seek out any necessary medical assistance that they deem may be required as a result of attending Phoenix Karate Inc, although I understand that there is no obligation upon them to do so.
I Do FURTHER UNDERSTAND AND AGREE that I shall not purchase weapons, sparring equipment or any other martial arts karate supplies and equipment, elsewhere, for use inside the facilities at Phoenix Karate Inc. Equipment not purchased through Phoenix Karate Inc will not be permitted inside the facilities.
I hereby acknowledge that I have read this RELEASE AND ACKNOWLEDGEMENT carefully and understand and agree to its terms.