• Shogun Fight Collective, LLC. Release and Card Authorization Update

    You MUST be 18+ to sign this form. Only one form is required per family (or family plan) - please utilize the "additional members" option to list each member on your plan. Any questions or concerns, please contact us.
  • Date of Birth*
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  • Format: (000) 000-0000.
  • Red_Warning-Attention

    Member's Age is under the required 18+ years of age to sign this form. 

    A parent/guardian MUST fill out this form.
  • Date - autofill
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  • Person 2 - Date of Birth
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  • Person 3 - Date of Birth
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  • Person 4 - Date of Birth
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  • Release Agreement

  • ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT
    In consideration of being allowed to participate on behalf of SHOGUN FIGHT COLLECTIVE, LLC. martial arts program and related events and activities, the undersigned acknowledges, appreciates, and agrees that:

    Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,
    I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
    I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. I acknowledge that SHOGUN FIGHT COLLECTIVE, LLC. is adhering to and exceeding CDC guidelines to ensure proper precautions and willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,
    I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS SHOGUN FIGHT COLLECTIVE, LLC., their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law; and,
     

    In consideration for my attendance and participation in this studio’s martial arts training, I, the student/parent, acknowledge the existence of certain inherent risks in this type of training and hereby agree to assume all risks. I further relieve the studio, its management, assigned staff, and fellow students from any liability resulting from personal injury or loss of personal belongings. I also hereby state the students named above are physically fit to take the prescribed course of instruction and do so of their own free will for an agreed-upon fee. I understand there is a refund policy agreed upon, and any and all monies I will pay to this studio follow said policy.
     

    BY SUBMITING THIS FORM YOU AGREE TO THE FOLLOWING:

    By submitting this form, I hereby agree and grant SHOGUN FIGHT COLLECTIVE, LLC. permission to use my likeness in photographs, video, or other digital media in any and all of its publications, including web-based publications / social media, without payment or other consideration. I waive any right to inspect or approve the finished product wherein my likeness appears, and I understand and agree that all media will become the sole property of SHOGUN FIGHT COLLECTIVE, LLC., and sharable upon request.
     

     FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)

    This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.
     

    I HAVE READ THIS AGREEMENT, RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

  • Billing Update Agreement

  • BY SUBMITING THIS FORM YOU AGREE TO THE FOLLOWING:

    By submitting this form, I/We hereby agree and authorize SHOGUN FIGHT COLLECTIVE, LLC., its successors, assigns or authorized payment processor permission to enable and continue charging monthly auto-processed payments electronically, with the payment method on file for the recurring membership tuition associated with the student(s) submitted above. Cancelling or putting a hold on your program requires a 30-day, written/digital notice to SHOGUN FIGHT COLLECTIVE, LLC. by messaging via the Fit by Wix app, emailing the studio, or sending a notice via USPS mail to our mailing address (60 Barrett Dr., Ste. C - Bsmt, Webster, NY 14580) and completing our Membership Adjustment Form. Without these, memberships will continue to be billed, and are non-refundable. Should a payment be scheduled for automatic processing within this period of time, payment cannot be canceled, and must process.

    I understand that: This authorization agreement replaces any prior recurring payment authorization given to the previous ownership; My current tuition amount will remain unchanged unless otherwise communicated in advance; My billing date will remain unchanged if previously billed on the 5th or 20th of the month. If my billing date was the 10th of the month, I understand and accept the new billing date request selection below; This authorization will remain in effect until my membership is properly canceled in accordance to the terms above; It is my resonsibility to notify SHOGUN FIGHT COLLECTIVE, LLC. if my payment information changes; I understand that insufficient funds, declined transactions, or expired payment methods may result in failed payments, and I am responsible for promptly updating my payment information and notifying the studio.

     

    I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

  • Please indicate your requested billing date:*

  • **Please be aware: your billing date will remain unchanged if currently billed on the 5th or 20th of the month. If your billing date is currently the 10th of the month, it will be updated to the date selected here.

  • Today's Date*
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  • Should be Empty: