Kyung’s St. Vital Taekwondo Student Agreement Form

I hereby apply for membership into Kyung’s St. Vital Taekwondo Do-Jang, and I fully understand and agree:*

That my presence and activities are completely at my own risk, and I do hereby indemnify, release, and forever discharge Kyung’s St. Vital Taekwondo, its instructors, members, agents, and any other person or persons connected with the said do-jang against and from all liability, and responsibility, and from all claims for personal injuries, or any loss of personal property sustained by me, or injuries or damage to person or property of others caused by me while engaging in taekwondo, or in activities of the said, or while in or near the premises or place of activity of the said do-jang, andThat the undersigned assumes all responsibility for transportation, including safe arrival before and safe departure after any and all activities related to Kyung's St. Vital Taekwondo Dojang, or any of its instructors, members, agents, and any other person or persons connected with the said group, who will not be held liable for or responsible for any issues or concerns related to transportation.That I will abide by the in-class and out-of-class rules and regulations and conduct myself so that I will not disgrace the honour of the membership, and I will not attempt to teach any of the aspects of taekwondo elsewhere except with the expressed and written consent of the Master.

Please note that current in-class and out-of-class rules and facility information can be accessed at any time from the following website address:

https://docs.google.com/document/d/e/2PACX-1vTYu6K730NikdRqTQSd833ArVMJFCHQilJg6DXaeAGKOir0f5tgR9t939SIF5zaTQ/pub

By signing below I acknowledge that I have read the foregoing Liability Release Waiver and understand its contents; that I am at least eighteen (18) years old and fully competent to give my consent; That I have been sufficiently informed of the risks involved and give my voluntary consent in signing it as my own free act and deed; that I give my voluntary consent in signing this Liability Release Waiver as my own free act and deed with full intention to be bound by the same, and free from any inducement or representation.

Student's Full Name*

First NameLast Name

Date of Birth*

Date

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Primary Phone Number*

Secondary Phone Number (Optional)

Please enter a valid phone number.

Primary Email Address *

Confirmation Emailexample@example.com

Secondary Email Address (Optional)

example@example.com

Any previous martial arts experience?

Any medical conditions that may affect your ability to perform in class (ex-asthma, previously broken bones, arthritis, joint problems, diabetes, sports injuries, heart problems, etc.) Alternatively, please feel free to speak to an instructor directly regarding any health information” .

Please note that if any medical conditions are listed above, it is the responsibility of the participant to obtain medical clearance from a doctor before taking part in the physically demanding training offered.

How did you hear about us?

SIGNATURE OF PARENTS/GUARDIANS IF UNDER 18 YEARS*

Date Signed*

Date

Kyung’s St. Vital Taekwondo Student Agreement Form 2025-2026

Student Liability Waiver