Friday, August 20, 2010

Karate Waiver

***Please copy and paste the below form into a word document, sign and return to Sensei Tower at student's first class. No student will be allowed to participate in class until this waiver is signed and turned in.***

Funakoshi Karate

Injury waiver and covenant not to sue

I ____________________________________ as the Parent/Guardian of __________________________ do hereby recognize and acknowledge that Funakoshi Karate is a dynamic and traditional martial art that teaches through example and demonstration, hand to hand combative techniques, as well as fighting techniques, and physical fitness conditioning exercises. I recognize that there is a potential for injury when engaged in these activities even under close supervisions of an affiliated instructor. I understand that injuries that may occur include but are not limited to: broken fingers and or toes, swollen lips, bruises, contusions, sprains, strains, dislocations, blisters, lacerations and may even include death. I forever hold Funakoshi Karate International, its governing body and the instructors, as well as the parents or guardians of other students and other students harmless and covenant not to sue for any injury incurred during normal instruction and during normal class activities. This waiver is not binding in the event of negligence committed by any of the above mentioned individuals.

Signature                                                                                                                                             Date

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