Signup

I,{name}, have enrolled in the martial arts program offered through Japanese Karate Academy aka Nihon Karate-Do Misogi-Kan. I recognize that the program may involve strenuous physical activity including, but not limited to, muscle strength and endurance training, cardiovascular conditioning and training, and other various fitness activities. I hereby affirm that I am, to the best of my knowledge, in good physical condition and do not suffer from any known disability or condition which would prevent or limit my participation in this program. I acknowledge that my enrollment and subsequent participation is purely voluntary and in no way mandated by Japanese Karate Academy.  I further certify that I am at least 18 years of age. If under 18, my parent/guardian is the below signed. 

In consideration of my participation in this program, I,{name}, hereby release Japanese Karate Academy and its agents from any claims, demands, and causes of action as a result of my voluntary participation and enrollment. I fully understand that I may injure myself as a result of my enrollment and subsequent participation in this program and I, {name}, hereby release Japanese Karate Academy and its agents from any liability now or in the future for conditions that I may obtain. These conditions may include, but are not limited to, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, heat exhaustion, injuries to knees, injuries to back, injuries to foot, heart attacks or any other illness or soreness that I may incur, including death.

I HEREBY AFFIRM THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE STATEMENTS.

{sign_date}