• Riverbend Karate, member SWKKF

    REGISTRATION, INFORMED CONSENT AND ASSUMPTION OF RISK AGREEMENT
  • WARNING !    WARNING: READ CAREFULLY. BY SIGNING THIS DOCUMENT YOU GIVE UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE OR TO CLAIM COMPENSATION FOLLOWING AN ACCIDENT. CLARIFY ANY QUESTION OR CONCERN BEFORE SIGNING.

  • Format: (000) 000-0000.
  • Date of Participant Birth *
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  • Format: (000) 000-0000.
  • Primary Class Choice *
  •  Registration Fee $299.00 Mid Sept to Mid May, Includes obligatory annual Shintani Federation fee of $84.00

  • Payment Method *
  • How did you hear about our club?*
  • A. I have read this waiver and I agree to observe all the club rules and instructions and to follow the requests of instructors established for the purpose of maintaining order and protecting members from injury. I acknowledge that while Riverbend Karate Association strives to provide a safe training environment, karate is an activity that involves risk, including the possible risk of severe or fatalinjury. I further agree that the members’ likeness may be used from time to time in promotional media.  I recognize the inherent risks and on behalf of myself, heirs and successors, hereby release the Instructors, Directors and other members of the Riverbend Karate Association and Edmonton Public/ Catholic Schools FROM ANY AND ALL LIABILITY for any injury, damage, loss, or expense, including liability for negligence, which I may suffer while participating in the club activities.

  • B. The Riverbend Karate Association is collecting this information in accordance with the Personal Information Privacy Act (2003). This information will be used to maintain membership lists under the requirements of the Societies Act (1980), to contact members about the club or training times and in the event of an emergency with a member while training. This information will not be shared with any third parties except in case of medical emergency without prior written consent. By signing this form, you consent to this use of the information you provide.

  • Today's Date*
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  • INFORMED CONSENT AND ASSUMPTION OF RISK

    1.     This is a binding legal agreement. Clarify any questions or concerns before signing. As a Participant in the sport of Karate and the orientation, instruction, activities, programs, and services of Karate (collectively the “Activities”), the undersigned, being the Participant and the Participant’s Parent/Guardian (collectively the “Parties”), acknowledge and agree to the terms outlined in this document:
     
    Disclaimer
    2.     Riverbend Karate Association, its directors, officers, committee members, members, employees, coaches, volunteers, officials, participants, agents, sponsors, owners/operators of the facilities in which the Activities take place, and representatives (collectively the “the Organization”) are not responsible for any injury, personal injury, damage, property damage, expense, loss of income or loss of any kind suffered by the Participant during, or as a result of, the Activities, caused in any manner whatsoever including, but not limited to, the negligence of the Organization.

  •                         Description of Risks

    3.     The Parties understand and acknowledge that:

    a)     The Activities have foreseeable and unforeseeable inherent risks, hazards and dangers that no amount of care, caution or expertise can eliminate, including without limitation, the potential for serious bodily injury, permanent disability, paralysis and loss of life;
    b)     The Organization may offer or promote online programming (such as webinars, remote conferences, workshops, and online training) which have different foreseeable and unforeseeable risks than in-person programming;
    c)      The Organization has a difficult task to ensure safety and it is not infallible. The Organization may be unaware of the Participant’s fitness or abilities, may give incomplete warnings or instructions, may misjudge weather or environmental conditions, and the equipment being used might malfunction; and
    d)     The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization and COVID-19 is extremely contagious.  The Organization has put in place preventative measures to reduce the spread of COVID-19; however, The Organization cannot guarantee that the Participant will not become infected with COVID-19.  Further, attending the Activities could increase your risk of contracting COVID-19.  
     

  •                     Description of Risks - continued

     

     4.     The Participant is participating voluntarily in the Activities. In consideration of that participation, the Parties hereby acknowledge that they are aware of the risks, dangers and hazards and may be exposed to such risks, dangers and hazards. The risks, dangers and hazards include, but are not limited to:  

    a)      falls, collisions and loss of control, and contact with other participants, spectators, officials, equipment, barriers, fixtures, posts, walls and other fixed or moving objects;

    b)     head injuries, including concussion and blunt head trauma, whether or not protective equipment is worn, and neck and spinal cord injuries that may result in permanent paralysis or brain damage;

    c)      fractures, dislocations, abrasions, lacerations, strains, sprains, tears and internal injuries;

    d)     strikes, punches, kicks, blocks, sweeps and blows to the head, face, throat, torso, groin and limbs, whether intended or accidental and whether or not within the permitted level of contact, including excessive, uncontrolled or unexpected contact, and accidental contact with a partner’s or opponent’s hand, foot, elbow, knee or head, and resulting eye, dental, ear and testicular injuries;

    e)      throws, sweeps, takedowns, falls to the floor, joint locks, restraints, chokes, groundwork and impact with the training surface, and self-defence or scenario training involving grabs, holds, restraints, simulated assault and adrenal-stress conditions;

    f)       being struck by, or striking another with, a Shindo staff or other training weapon, or an implement that is dropped, deflected, released or otherwise not controlled, contact with makiwara, pads, shields, bags and other impact equipment, and repetitive impact and overuse injury arising from kata, kihon and conditioning drills;

    g)      disparity in size, weight, age, rank, strength or experience between training partners or opponents, training alone, unsupervised, or in a virtual or online session where the space, flooring, equipment and supervision are outside the Organization’s control, and participation in tournaments, group travel, billeting, overnight accommodation and associated social activities;

    h)     playing surface, facility, venue and premises conditions, including wet, uneven, obstructed, defective, dangerous or unsafe conditions, and extreme weather, poor visibility and altitude;

    i)       mechanical failure, or the negligent design, manufacture, assembly, maintenance or use, of equipment, and failure to wear or properly fit protective equipment;

    j)       strenuous exertion and the resulting risk of cardiac events, heat exhaustion, hypothermia, dehydration and fatigue, and the transmission of infections and communicable diseases;

    k)      the Participant’s own negligence or failure to participate within their own ability or within designated areas, the negligent or reckless conduct of others, and negligent advice, instruction, supervision, coaching or officiating; and

    l)       inadequate or delayed first aid, medical assessment or emergency response, including at remote locations, and travel to, from and between venues and events.

  •             Terms

     

    5.     In consideration of the Organization allowing the Participant to participate in the Activities, the Parties agree:

    a) Representations. The Participant represents that their mental and physical condition is appropriate for participation in the Activities and that they have sought medical advice where they considered it necessary; that it is their sole responsibility to assess whether any Activity is beyond their ability, and to select, maintain and securely fit their equipment and protective equipment; and that they are not relying on any statement made by the Organization other than what is set out in this Agreement.

    b) Assumption of Risk. The Participant freely accepts and fully assumes all risks, dangers, and hazards arising out of, associated with, or related to participation in the Activities, including the possibility of personal injury, death, property damage, expenses, and related loss, including loss of income.

    c) Release and Waiver of Claims. The Participant waives all claims that they have or may in the future have against the Released Parties, and forever releases and discharges the Released Parties from all liability for any claims, demands, actions, damages (including direct, indirect, special and consequential damages), losses, judgments and costs, including legal fees (collectively, the “Claims”), that might arise out of, result from or relate to participation in the Activities, even though such Claims may have been caused by any cause whatsoever, including the negligence, gross negligence, negligent rescue, omissions, carelessness, breach of contract or breach of any statutory duty of care of the Released Parties, including any duty of care owed by them as an occupier of the premises on which the Activities take place under applicable occupiers’ liability legislation or at common law. The Participant further agrees not to commence or continue any claim, action or proceeding against the Released Parties in respect of those matters.

    d) Indemnity. The Participant agrees to indemnify and hold harmless the Released Parties from and against all Claims arising out of the Participant’s participation in the Activities, including any claim brought by a third party or by any person claiming through the Participant.

    e) Emergency Care. The Organization may secure transport to emergency medical services as it considers necessary for the Participant’s immediate health and safety, and the Participant is financially responsible for those services.


     
    6.     In consideration of the Organization allowing the Participant to participate, the Parties agree:
    a)     That the Parties are not relying on any oral or written statements made by the Organization or their agents, whether in brochure or advertisement or in individual conversations, to agree to be involved in the Activities; and
    b)     That the Organization is not responsible or liable for any damage to the Participant’s vehicle, property, or equipment that may occur as a result of the Activities.
    General
    7.     The Parties agree that in the event that they file a lawsuit against the Organization, they agree to do so solely in the province of Alberta Canada and they further agree that the substantive law of Alberta will apply without regard to conflict of law rules.
     
    8.     The Parties expressly agree that this Agreement is intended to be as broad and inclusive as is permitted by law and that if any of its provisions are held to be invalid, the balance shall, notwithstanding, continue in full legal force and effect.

  •         Acknowledgement


    9.     The Parties acknowledge that they have read this agreement and understand it, that they have executed this agreement voluntarily, and that this Agreement is to be binding upon themselves, their heirs, their spouses, parents, guardians, next of kin, executors, administrators and legal or personal representatives.

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