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Participation Waiver/Release

In consideration of being permitted to participate in any way in the Twin City Isshinryu, TCI Program indicated below and/or being permitted to enter for any purpose any restricted area (here in defined as any area where in admittance to the general public is prohibited), the parent(s) and/or legal guardian(s) of the minor participant named below agree:

1. The parent(s) and/or legal guardian(s) will themselves inspect all equipment and premises and wil instruct the minor participant that prior to participating in the below karate activity or event, he or she should inspect the facilities and equipment to be used, and if he or she believes anything is unsafe, the participant should immediately advise the officials of such condition and refuse to participate. 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/WE fully understand and acknowledge that:

(a) There are inherent risks and dangers associated with participation in all martial arts and more specifically in all TCI events and activities, which could result in bodily injury, partial and/or total disability, paralysis and death.

(b) The social and economic losses and/or damages, which could result from these risks and dangers described above, could be severe.

(c) These risks and dangers may be caused by the action, inaction or negligence of the participant or the action, inaction or negligence of others, including, but not limited to, the Releasees named below.

(d) There may be other risks not known to us or are not reasonably foreseeable at this time.

3. I/WE expressly accept and assume for myself and/or my minor children  such risks and responsibility for the losses and/or damages following such injury, disability, paralysis or death, however caused and whether caused in whole or in part by the negligence of the Releasees named below.

4. I/WE HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE the TCI facility used by the participant, including its owners, instructors, promoters, lessees of premises used to conduct the martial arts event or program, premises and event inspectors, underwriters, consultants and others who give recommendations, directions, or instructions to engage in risk evaluation or loss control activities regarding the TCI facility or events held at such facility and each of them, their directors, officers, agents, employees, all for the purposes herein referred to as “Releasee”...FROM ALL LIABILITY TO THE UNDERSIGNED, my/our personal representatives, assigns, executors, heirs and next to kin FOR ANY AND ALL CLAIMS, DEMANDS, LOSSES OR DAMAGES AND ANY CLAIMS OR DEMANDS THEREFORE ON ACCOUNT OF ANY INJURY, INCLUDING BUT NOT LIMITED TO THE DEATH OF THE PARTICIPANT OR DAMAGE TO PROPERTY, ARISING OUT OF OR RELATING TO THE EVENT(S) CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEE OR OTHERWISE.

5. IT IS FURTHER HEREBY NOTED that the activities engaged in by the undersigned are not able to be performed in a completely socially distanced manner and that there are inherent risks to exposure to the COVID-19 virus regardless of any precautions taken by the participants.  It is the intent of the undersigned to EXPRESSLY WAIVE any and all liability for exposure to the COVID-19 virus that may occur through the activities engaged in as a part of marital arts training.  

5. I/WE HEREBY acknowledge that THE ACTIVITIES OF THE EVENT (S) ARE INHERENTLY  DANGEROUS and involve the risk of serious injury and/or death and/or property damage. Each of THE UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES.

6. EACH OF THE UNDERSIGNED further expressly agrees that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the Province or State in which the event is conducted and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding continue in full legal force and effect.  No provision shall be construed against the drafter of the is agreement and all terms shall bear their common meaning and shall be fully binding upon the undersigned.  This release is voluntarily and freely made without any duress with knowledge that it is a precondition to the voluntary activities engaged in by TCI.  I confirm that I have read this agreement and agree to be bound by all terms contained within.  INITIAL HERE ____________

7. On behalf of the participant and individually, the undersigned partner(s) and/or legal guardian(s) for the minor participant executes this Waiver and Release. If, despite this release, the participant makes a claim against any of the Releasees, the parent(s) and/or legal guardian(s) will reimburse the Releasee for any money, which they have paid to the participant, or on his behalf, and hold them harmless.

8. I/WE HEREBY grant permission for TCI to use photographs and/or video of myself and/or minor participant(s) taken during TCI class times/events. I/we understand that the photographs and/or video may be used in publications, news releases, online, and in other communications related to the mission of TCI.

****** See other side ******

I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.   INITIAL HERE _____________

Facility/Releases: Twin City Isshinryu and its instructors, guest instructors

Signature / Parent or Guardian Signature (if minor){____________________________________________} Date:__________________

Printed Name of Participant _______________________________________________________________________________________

Address of Participant ____________________________________________________________________________________________

Student’s Name: ________________________________________Birthday: _____________________________   Age: _____________

Student’s Name: ________________________________________Birthday: _____________________________   Age: _____________

Student’s Name: ________________________________________Birthday: _____________________________   Age: _____________

Student’s Name: ________________________________________Birthday: _____________________________   Age: _____________

Contact Information:  Cell Phone: _____________________   Email: _____________________________________________________

Medical Concerns / food allergies: __________________________________________________________________________________

Emergency Contact:  Name: _____________________________________________   Cell Phone: ______________________________