Centreline Kung Fu Hall

Registration Form (Under 18)

Please fill in the form below. Fields with red asterisk are mandatory entries. Registration for up to 3 children.
Name of Student 1 *

First NameLast Name
Date of Birth*

MonthDayYear
Date
Does this child have any physical ailments, injuries, impairments, learning disabilities that we should know about?
What is the primary benefit you seek for your child, from this class?
What sports, recreational activities, hobbies does your child participate in now?
Are you registering more than one child?

Yes
This next section is to register 2 additional children.

If none, scroll down to Information of Parent(s).
Name of Student 2

First NameLast Name
Date of Birth

MonthDayYear
Date
Does this child have any physical ailments, injuries, impairments, learning disabilities that we should know about?
What is the primary benefit you seek for your child, from this class?
What sports, recreational activities, hobbies does your child participate in now?
Name of Student 3

First NameLast Name
Date of Birth

MonthDayYear
Date
Do this child have any physical ailments, injuries, impairments, learning disabilities that we should know about?
What is the primary benefit you seek for your child, from this class?
What sports, recreational activities, hobbies does your child participate in now?
Information of Parent/Guardian(s)
Name of Parent/Guardian 1*

First NameLast Name
Phone Number*
E-mail
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Parent/Guardian 2

First NameLast Name
Phone Number

Area CodePhone Number
E-mail
example@example.com
PAYMENT: Monthly fees are to be remitted on the first class of every month. Automatic invoicing for credit card transaction will be set up after the initial registration, so you will receive a reminder. If you prefer to pay using a different method, let us know at centreline@kungfutoronto.com*

Acknowledged
ATTIRE: The dress code consists of black fitness pants of your choosing and a school T-shirt to be purchased upon your first month's commitment. (In the meantime, please wear any black or dark-toned short-sleeved T-shirt.) Remove any dangly or protruding jewelry and wearable technology should be removed before class. Students are to wear a change of sneakers on the training floor. The flattest possible sneakers are best for Kung Fu practice.*

Acknowledged
HYGIENE: In this class, students will engage in close-quarters interactions and drills. To ensure a comfortable environment for all, please maintain personal hygiene in check (oral and body), as well as clean clothes. Let's make our learning experience enjoyable for everyone.*

Acknowledged
RESPONSIBILITY: Students should carry their own items (bags, shoes, jackets, etc.) when entering and exiting the school. We kindly ask that parents not carry them in for them. This practice is designed to instill responsibility and ownership for the activities they participate in.*

Acknowledged
NOTIFICATION OF ABSENCE: Please notify us if your child will be absent from class due to a general holiday or academic schedule. Understanding that such absences may be common among other students, your timely communication enables us to make necessary adjustments, such as potentially cancelling a class if a significant number of absences are anticipated.*

Acknowledged
Emergency Contact Information
Name of Emergency Contact

First NameLast Name
Phone Number
Relationship to Student(s)

General Information

(Not required.)
How did you hear about us?
Do you have any comments or questions you would like addressed?

Release of Liability

ACKNOWLEDGEMENT OF RISK AND RELEASE OF LIABILITY
For Participants Under the Age of Majority in the Province or Territory in which the Athletic Activities are Provided by Centreline Kung Fu Hall

WARNING: THIS AGREEMENT WILL AFFECT YOUR LEGAL RIGHTS.
PLEASE READ IT CAREFULLY!

The Parent/Guardian Must Read and Understand this Waiver Prior to the Minor Participating in Athletic Activities

The following waiver of all claims, release from all liability, assumption of all risks, and other terms of this agreement are entered into by me on behalf of the Minor Participant (the “Minor”) with and for the benefit of: their directors, officers, employees, volunteers, business operators, agents and site property owners or Occupiers (“Centreline Kung Fu Hall”). Occupiers is defined in accordance with the definition of Occupiers contained in the Occupiers Liability legislation applicable to the Province or Territory in which the Athletic Activities are provided by Centreline Kung Fu Hall.

Please Check Each item below after Reading and Understanding each item:
1. I am the Parent/Guardian of the Minor and am executing this waiver on behalf of the Minor in my capacity as Parent/Guardian and with the intent that this waiver be binding on me and the Minor for all legal purposes.
2. I am aware that there are inherent and significant risks (“Risks”) associated with the participation in Athletic Activities. I am aware that those Risks include, but are not limited to, the potential for serious personal injury caused by any event or any condition of the facility or equipment where Athletic Activities are provided by the Organization, and health risks such as transient lightheadedness, fainting, abnormal blood pressure, chest discomfort, muscle cramps or soreness, and nausea. I understand the Risks are relative to my own state of fitness and health (physical, mental and emotional), and to the awareness,care and skill with which I conduct myself while participating in Athletic Activities.
3. I freely accept and fully assume all responsibility for all Risks and possibilities of personal injury, death,property damage or loss resulting from my participation in Athletic Activities. I agree that although the Organization has taken steps to reduce the Risks and increase safety of the Athletic Activities, it is not possible for the Organization to make the Athletic Activities completely safe. I accept these Risks and agree to the terms of the waiver, even if the Organization is found to be negligent or in breach of any duty of care or any obligation to me in my participation in Athletic Activities.
4. I acknowledge on behalf of the Minor the Minor’s obligation to immediately inform the nearest employee of Centreline Kung Fu Hall if the Minor feels any pain, discomfort, fatigue or other symptoms that he or she may suffer during and immediately after his or her participation in Athletic Activities. I understand the Minor may stop participation at any time, and may be requested to stop by an employee of the Organization who observes any symptoms of distress or abnormal response.
5. Athletic Activities include but are not limited to contact and non-contact sports, fitness activities, personal training instruction and activities, use of facilities, and fitness programs and services provided to the Participant by Centreline Kung Fu Hall.
6. In addition to consideration given to the Organization for my participation in Athletic Activities, I and my heirs, next of kin, executors, administrators and assigns (collectively my “Legal Representatives”) agree:
a. To waive all claims that I have or may have in the future against the Organization; to release and forever discharge the Organization from all liability for all personal injury, death, property damage, or loss resulting from my participation in the Fitness Activities due to any cause, including but not limited to negligence (failure to use such care as a reasonably prudent and careful person would use under similar circumstances), breach of any duty imposed by law, breach of contract or mistake or error of judgment of the Organization; and

b. To be liable for and to hold harmless and indemnify the Organization from all actions, proceedings,claims, damages, costs demands including court costs and costs on a solicitor and own client basis, and liabilities of whatsoever nature or kind arising out of or in any way connected with my participation in Athletic Activities.

c. I agree that this waiver and all terms contained within are governed exclusively by the laws of the Province or Territory of Canada in which the Athletics Activities are provided to me by the Organization. I hereby irrevocably submit to the exclusive jurisdiction of the courts of that Province or Territory. Any litigation to enforce this waiver must be instituted in the Province or Territory in which the Athletic Activities are provided by the Organization.
7. I confirm that I have had sufficient time to read and understand each term in this waiver in its entirety, and have agreed to the terms freely and voluntarily. I understand that this waiver is binding on me and my Legal Representatives.
Parent's Signature*

Clear

Process your payment below.

Intro Program (3 classes)$35.00CAD

Number of kids

Full Month$90.00CAD

Number of kids

Total $0.00CAD

Credit Card

What will be your start date?

DayMonthYear
Date
Should be Empty:

Registration Form (Under 18)

This next section is to register 2 additional children.

Information of Parent/Guardian(s)

Emergency Contact Information

General Information

Release of Liability

Credit Card