Deer Dojo Registration Spring 2025

Deer Dojo Registration Form-Fall 2025
Student's Name*

First NameLast Name
Age*
Birthday*

MonthDayYear
Date
Male or Female*
Parent's Name (if student is a minor)

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Allergies or Medical Conditions
Emergency Contact Name/Relation*
Emergency Contact Number*
Enter a valid phone number different from above.
Class*
Class Prices*
I understand and agree

*That karate is a physical contact sport and may result in injury and I will not hold Deer Dojo/Trujillo Martial Arts liable for injury to student when participating in all activities. Furthermore, I waive all rights to claims for damages I have against Deer Dojo/Trujillo Martial Arts and its representatives, successor, and assigned for any and all injuries or theft suffered either by myself and/or the aforementioned student and/or other family members while being transported to or from the dojo, or while participating in events at or sponsored by Deer Dojo. *There are no refunds for registration fees or purchased uniforms or equipment. *I acknowledge I and/or my family memebers may come in contact with contagious diseases and viruses and voluntarily assume the risk such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by contagious diseases and viruses may result from the actions, omissions, or negligence of myself and others, including, but not limited to, employees, independent contractors, volunteers, and program participants and their families. I release Deer Dojo/Trujillo Martial Arts, it’s instructors, independent contractors, and all associates from liability or harm, injury, or death pertaining to COVID-19 and other contagious diseases and viruses. *Students may not be allowed to participate in self-defense and/or partner drills if they are wearing any type of jewelry or watches. *Students may not be allowed to participate and no refund will be given if they do not follow instructions or act in such a way that is unsafe for them and/or other students. This will be solely at the instructor’s discretion. *Karate is a physical sport which is conveyed to muscle memory through tactile senses. Therefore, I understand that instructors will use imagery, touch, and sound kinesiological principles to convey correct stance and motion. *I understand that Kojosho and the Kojosho Forms are protected under Federal and State copyright and trademark laws and are not to be performed at any public event or shared on social media without the express written approval of the Chief Instructor. *Students will not be allowed to participate until release form is signed.
Student Signature (parent or guardian if student is a minor)

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Date*

MonthDayYear
Date
New Students only, whom may we thank with $20 cash for referring you?

First NameLast Name

Initial after each of the following.
Please be on time to class. Students who are late to class will be required to do some warm up exercises and stretching before joining class to make sure muscles are ready to work. If too much of the class is missed, it may not be counted as attendance toward testing.*
Students not wearing their complete gi will line up at the end, no matter their rank.*
Especially for adult students, if at any time you feel like your body is not able to handle what we are asking you to do, please, let us know and we will try to modify to make it work for you.*
The junior progress cards need to be brought to each class. Students will keep track of their attendance on these cards. All items on the card must be completed to be eligible to test. More than one card may be completed in a semester, depending on student's age. If cards are lost, that card must be restarted except for attendance.*
Please do not wear watches or jewelry of any kind to class. For your safety and the safety of others, students wearing watches and/or jewelry will not be allowed to participate in self-defense, sparring, or any other interactive drills.*
Please do not wear jeans to class (even under your gi) as they restrict movement.*
Please have your hair pulled back out of the way, especially when sparring and doing self-defense. It is not safe if you cannot see properly or it gets tangled in someone's fingers.*
Parents, siblings, and students waiting for your class, please keep your voices down. We are conducting a class and loud voices can be distracting and make it difficult for the teacher to be heard.*
Do not drop off students more than 10 minutes prior to their class time or pick students up more then 10 minutes after their class ends as we do not have anyone supervising students not on the mat.*
If your child uses our kids play table, please make sure they clean up whatever they used before you leave.*
Should be Empty:

Initial after each of the following.