Please complete the form below prior to attending class. There are "No Contract Obligations" with our academy.

First Name: Required

Last Name: Required

Phone: A phone number required.

Email:

Class Type:

Gender: Female Male

Message:

SECTION B: Release and Waiver of Liability and Indemnity Agreement
(Read Carefully Before Signing)

1. The parent(s) and/or legal guardian(s) hereby grant permission to participate in martial arts programs, events, or activities operated or sponsored by the Tensho Goju Academy of Martial Arts and Science.
I understand and agree that, if at any time, I feel anything to be UNSAFE; I will immediately take all precautions to avoid the unsafe area and REFUSE TO PARTICIPATE further.
2. I understand and acknowledge that a participant may incur personal or bodily harm while participating in martial arts -related activities, including but not limited to activities described as running, jumping, kicking, punching, rolls, throws, break-falls and physical contact sparring, etc.

3. By signing this agreement, I assume all risks inherent in these activities and accept full responsibility for any and all damages or injuries of any kind; but I am also aware that reasonable care and supervision will be exercised by the instructor(s) to provide for the general well-being of myself/child.

4. I further acknowledge placing my trust in myself/child to adhere to proper standards of conduct and to follow the rules set forth by the instructor(s) in charge of the activity, the Tensho Goju Instructor Manual and me as parent/guardian.

5. I understand and assume the risks described above and those inherent with such activities, and I individually, or on behalf of my child, do hereby release and discharge and covenant not to sue the Tensho Goju Academy/Dojo/School, its instructors, directors, employees, agents and/or volunteers for this activity and agree to hold them harmless from any and all claims whatsoever arising from the conduct of any person(s) which results in the injury or loss to my child or myself.

6. I accept responsibility of notifying the Tensho Goju instructor(s) of any pre-existing conditions affecting me or my child(ren).

7. I further understand and acknowledge that the Tensho Goju Academy/School will not allow me or my child to participate in such activities without my acceptance of and signature on this agreement.
8. I also fully understand that any fee paid for children, or myself and any other family care member to participate in this martial arts activity is NOT REFUNDABLE, and hereby waive my rights for redemption of said fee.

9. Due to the Coronavirus (COVID-19) pandemic, our business is taking extra precautions to enhanced sanitation/disinfecting procedures in compliance with CDC guidance.

  • Participants must wear mask to enter the facility.
  • Participants must wash hands prior to training and immediately after.
  • All equipment will be sanitized prior to training and immediately afterwards
  • Participants must wear mask to enter the facility.
  • Maximize social distancing when possible.10. Please refrain from entering the facility with symptoms that include:
  • Fever
  • Fatigue
  • Dry Cough
  • Difficulty Breathing

  • 11. I agree to the following:
  • I understand the above symptoms and affirm that I, as well as all household members, do not currently have, nor have experienced the symptoms listed above within the last 14 days.
  • I affirm that I, as well as all household members, have not been diagnosed with COVID-19 within the past 30 days.
  • I affirm that I, as well as all household members, have not knowingly been exposed to anyone diagnosed with COVID-19 within the past 30 days.
  • I affirm that I, as well as all household members, have not traveled outside of the country or to any city considered to be a “hot spot” for COVID-19 infections within the past 30-days.