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Participant Name

Age

Responsible Party (if under 18)

Phone Number

First class date (mm/dd/yy)

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Required Waiver of Liability Required Waiver of Liability I Understand and Agree to the waiver below

Harmless Release –

Parties – This is an agreement made between the PARTICIPANT and the RELEASEES. The person listed above, and the Responsible Party should the participant be minor, are hereby known as “PARTICIPANT”. Auza Li International, LLC., dba. Karate Mission Viejo, Mission West Academy of Martial Arts, Novastar Martial Arts (and any other names related to this LLC), its instructors, assistants, officers, managers, agents AND all other representatives jointly and separately are all known as the “RELEASEES”.

Harmless Release – I, the PARTICIPANT (listed above in this page under “Participant Name” and/or the person responsible for Participant, listed as “Responsible Party”) AGREE and UNDERSTAND that I will be doing martial arts classes at a location designated by the RELEASEES.

I am aware that practice of the martial arts is a contact sport that may include varied items/situations including but not limited to take downs, weapons training, physical training, joint manipulations, bodily strikes, kicks, punches, turns, steps, twists, and many others that may be HARMFUL and possibly DEADLY to me.
I AGREE to FULLY RELEASE the RELEASEES of ANY AND ALL liability, AND AGREE to hold them HARMLESS should any kind of injury and/or death happens to PARTICIPANT during, before, or after this(these) martial arts class(es), or as a result of the training WHETHER due to the negligence of the RELEASEES or otherwise.

Photo Release – I, the PARTICIPANT, give full permission to the RELEASEES to use my likeness and take photo and video of my training for a) Security Reasons b) Training purposes for Instructors c) Quality Control and d) for advertisement purposes.

Physical ability to perform – I (PARTICIPANT) am fully physically and mentally capable of withstanding this class and this type of training. I have made this fact known to RELEASEES prior to entering the lesson and I am fully aware of the dangers of training in martial arts.