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LIFE KI-DO MARTIAL ARTS REGISTRATION FORM

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Child must be a Primary student at Athena. Ages 3 1/2 – 6 only.

Should you have any questions or concerns, please contact Life Ki-do staff at info@lifekido.com.

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CHILD #1 INFORMATION

Add on a Life Ki-do T-shirt for only $10? *

CHILD #2 INFORMATION - leave blank if only registering one

Add on a Life Ki-do T-shirt for only $10?

PARENT/GUARDIAN CONTACT

Please enter the primary contact address for the participant(s) above:

How did you hear about Life Ki-do? *

RELEASE OF LIABILITY

This agreement is between Student named above & any parent/guardian or sibling hereinafter collectively referred to as Student and Life Ki-do LLC, Austin Martial Arts Academy, Empty Hands Incorporated, all special event programs, camp programs, its volunteers, its instructors, administrators, agents, owners, managers or independent contractors and all affiliated members and employees; hereinafter collectively referred to as Life Ki-do or LK.

In consideration of enrollment in any Life Ki-do Martial Arts program, the parent(s) and/or legal guardian(s) of the minor participant named below agree:

(1) When your child practices any martial art or self-defense system you/your child are "consenting to participate" and understand and acknowledge that there is an assumption of risk, especially if those systems are geared towards street protection. Practice, train and use this information at your OWN RISK. Practice safely.

(2) I/We acknowledge before signing this agreement that the techniques taught in LK programs are intended strictly for self-defense and physical health &   fitness purposes, and that these techniques are not to be used in a negative or aggressive manner against any person or property. I/We understand that the student may be expelled at any time from participation in a program or event if the instructors learn that the student used these techniques in a negative or aggressive manner against anyone or anything.

(3) I/We agree that I, my heirs, next of kin, legal representatives and assigns (a) will not make a claim against LK for any injury, death, or property damage   resulting directly or indirectly from any family member’s participation in a Life Ki-do program or event; and (b) will release and discharge LK from any claims or       demands arising from injury, death, or property damage to any family member caused by his/her participation in an LK program or event however caused and whether caused in whole or in part by the negligence of the Releasees named above.

(4) If the Student/Parent/Sibling has any emotional, mental or physical disabilities or illnesses, I have advised an LK representative of this fact and will obtain written consent from the Student’s physician or therapist to participate in LK programs and events.

(5) In the event of an injury, condition, or death that surpasses the capabilities of our Instructor’s, I/we hereby give permission to obtain qualified emergency medical assistance to my son/daughter and do not hold LK liable for such occurrence. We also understand that injuries received may be compounded or increased by negligent rescue operations or procedures of the Releasees.

(6) 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 laws of the State of Texas and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding continue in full legal force and effect.

(7) I agree to allow LK to use the student’s still or moving picture for any promotion and/or publicity relating to LK. I understand that I will not receive any compensation for such use.

(8) I agree that there have been no oral representations, statements, or inducements made apart from this written agreement.

(9) I have not requested nor received any warranties as to the effectiveness of any LK program.

(10)I promise to defend, indemnify, and hold harmless LK from any claims made by third parties alleging injury or damage resulting from the Student’s conduct and activities while on LK premises or during an LK sponsored event, from the Student’s conduct as an LK student, and from the Student’s use of any   techniques learned in an LK program.

(11)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 the 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.

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.

 

I HAVE READ AND VOLUNTARILY AGREE TO THE RELEASE OF LIABILITY TERMS ABOVE. *

PAYMENT INFORMATION - By Entering, I agree to the charge(s) and terms and conditions

SPRING 2019

Thursdays from 8:35 am-9:05 am.

Jan. 17 - May 23rd (No Class March 21st)

Miss a class?

Make it up in any age appropriate class at our Westlake or Lakeway locations!

WHO:

For Primary students attending Athena. Ages 3 1/2 - 6 only.

COST:

$83/month. Add on a Life Ki-do T-shirt for only $10

Please select one of the following forms of payment below: *

Your information will be sent via our secure website. Completing this registration form authorizes Life Ki-do to automatically charge/deduct the fee from your account.  Failure to attend does not constitute a refund or cancellation and returned transactions are subject to a $25 returned transaction fee. 
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