RELEASE FORM

The student signing this waives any cause of action or claim against Prescott Valley House Of Karate; their officers, directors, instructors, and employees for any injuries received resulting from instructional services rendered.

Please read all information below on this release form and sign in agreement.

Student/SCHOOL representations and release of liability:

The member applying warrants and represent that he/she/minor or student is in good physical condition and has not been advised by any Physician or Medical Facility that participation in the applied for course of training will in any way be adverse to the well being of the student.  Furthermore, member represents that the student is able and allowed to participate in exercise and various martial arts curriculum, which is provided by SCHOOL.  Student/parent/guardian understands that by participating in the martial arts program or by use of the facilities or equipment covered by this contract does present the possibility of accidental injury.  Student/parent/guardian assumes all risk associated with such participation within this program and holds SCHOOL harmless for any such injury or occurrence.  In addition, student/parent/guardian agrees to indemnify SCHOOL from any and all liability, which may arise against SCHOOL by such member or though any other third party as a result of training received by SCHOOL or by use of SCHOOL's facilities or equipment.  Student/parent/guardian understands that during the course of instruction, employees or higher degree student instructors of SCHOOL will be engaged in a course of conduct requiring physical contact, and he/she (or parent or guardian) gives full consent to such contact as is required by the training.  It is understood that due to the nature of the training which is being provided by SCHOOL that accidents do from time to time occur.  While all precautions will be taken to assure the safety of all students, it is impossible to guarantee that such accidents will not occur.  In the event that you are involved in an accident which subjects you to any injury, you agree to hold SCHOOL, Prescott Valley House Of Karate, any instructors , staff or representatives faultless; you further agree that neither you, a parent, a guardian or any other financially responsible person will take action against SCHOOL, Prescott Valley House Of Karate, staff, instructors or representatives as a result of such injuries. 

Age or Parental Consent Certification:

By signing this enrollment form, you are certifying that you are either of legal age or that you are signing this enrollment form as the parent or legal guardian of a minor, and by signing this enrollment form on behalf of any minor, you hereby agree that you shall be responsible for all payments due hereunder and that you will indemnify and hold SCHOOL harmless for any injuries, losses, or damages sustained to anyone as a result of the minor's participation in this program of instruction.

Governing Law:

This agreement shall be construed in accordance with the laws of the State of Arizona without regard to its conflict of laws principals.   This Agreement shall constitute the entire understanding with respect to the subject matter hereof and may be modified only in writing signed by both STUDENT and SCHOOL.  If any provision of this Agreement is determined to be invalid, illegal or unenforceable, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired thereby.

Bad Check Charges:

It is agreed that in the event that Prescott Valley House Of Karate receives any check returned as NSF or is returned by bank for any other reason, that student/parent/guardian will be responsible for a charge of $30 made payable to Prescott Valley House Of Karate.