The DOJO, inc. Risk Agreement and Consent Form AUTHORITY TO TREAT I, the undersigned, give the instructors, staff and responsible adults the power to authorize medical or other treatment of the person named above under “Student Name,” subject to the limitations listed below, if any. If I am not the person so named, I am the parent, guardian or adult responsible for the person named, and I have the legal right to grant this power. Treatment may be made without regard to whether I or any other parent, guardian or adult responsible has been contacted or has consented to the specific treatment, provided it does not conflict with the limitations outlined below. This authority begins on the date signed and continues indefinitely. By giving my authorization, I assume responsibilities for all decisions made, provided they are reasonable decisions under the circumstances based upon the knowledge and understanding of the person making the decisions, and I trust their judgment and offer the benefit of the doubt to them in any claim or legal proceeding. This presumption may only be overcome by clear and convincing evidence that they acted with malice or willful gross negligence, and, if so, they may still be liable. I Agree I understand that the instructors, senior students, or others may have some skills in first aid, CPR, and, at their discretion, I authorize them to use those skills and techniques to assist in any circumstance in which they judge their skills would be necessary or helpful. I Agree ADVISORY OF RIGHTS AND RESPONSIBILITIES Safety is not the sole responsibility of instructors and staff. Everyone in class is responsible for their own safety and the safety of those around them. All students have the right and responsibility to excuse themselves from any exercise they believe will be harmful to them. All students must evaluate each situation in the context of their skill and current physical condition, and conduct each drill in a manner that is safe. If an instructor gives an instruction that is unsafe for the student, it is the student’s responsibility to inform the instructor that the skill may be unsafe. The instructor will routinely excuse the student from unsafe exercises and drills. The instructor may ask for an explanation, and the student is expected to provide one. All students have a responsibility to train and conduct themselves in a manner that helps all students and instructors remain safe. Students must give those who are training enough room to avoid interfering and avoid being accidentally struck by someone else practicing, which is especially important when others are practicing with weapons. In the event of an injury, students have the right and responsibility to evaluate the extent of harm, stopping what they are doing even if it includes a partner, and determining if it is safe to continue. Unless a student is certain that further practice will not create or worsen a problem, all students are encouraged to stop what they are doing and inform an instructor. In the event of a serious injury or appearance of a serious injury, all students, instructors, staff and visitors, notably parents, have the right to call a stop to a particular training exercise. If a student notes an unsafe training situation, which may include a student performing a skill incorrectly, a student not being careful about others, a defect in a piece of training equipment, a potentially dangerous obstacle or condition on the floor, or anything else that may cause or lead to harm of students, instructors, staff, visitors or guests, then the student is expected to correct the situation if within his ability or notify an instructor or staff member immediately. If something is simple to correct, such as picking up a weapon left on the floor, the student should correct the situation. If the situation may require the authority of the instructor or staff, or if it is not a simple matter, then an instructor or staff member should be notified immediately. I Agree ASSUMPTION OF RESPONSIBILITIES AND RISK Martial arts is a potentially dangerous activity. Bumps, bruises, scrapes, scratches and soreness are commonplace, and most students will encounter this sort of minor injury from time to time in their training. More serious injuries are possible, including sprains, strains, twists, cramps and injuries of similar magnitude, and students can expect to encounter these injuries infrequently. The possibility of the more serious injury exists. Including fractured bones, broken bones, torn ligaments, though not all students encounter such serious injuries. There remains, despite safety precautions, the remote possibility of crippling or death, though this is certainly not expected in this martial arts class. I understand the above statement of risk, and I understand the rights and responsibilities of students. I assume responsibility for my own safety (or the safety of my child), understanding and accepting the risks involved with martial arts training including traveling to and from this or any other school or event. Even if the instructor has informed me that no serious injuries have ever happened in this school or with any of the instructors, I understand that this does not mean that there is no possibility of harm. By assuming this risk, I completely absolve all instructors, staff, guests, students, landlords, management companies and any and all other parties of liability for my harm, unless intentionally caused in criminal conduct. I Agree NOTICE AND CONSENT TO INSTRUCTORS This school seeks to make use of highly trained professional instructors, with both expertise and experience both in the art we teach and in teaching. Classes may be taught by the head instructor or any other qualified instructor. Should an instructor be unavailable for a given class, a junior instructor, senior student or guest instructor may teach. The choice of the instructor is left to the discretion of the school. I understand that I may not always have the instructor I desire, but I shall seek to learn from whomever is teaching, to show the respect due the position of teacher to whomever is teaching, and to conduct myself in accordance with the etiquette established at this school. I understand that I have the responsibility for my own safety without regard to who is teaching the class. I specifically consent to any instructor the school, instructors or staff feel are sufficiently qualified by any standards they set to teach the class. I specifically understand and agree that the full force of this document applies no matter who is teaching. I Agree NOTICE OF PHYSICAL CONTACT Complete martial arts training involves a wide variety of skills. While practicing these skills, students may have contact with any portion of the body. The groin may be the target of kicks, strikes and grabs. The chest, buttocks, groin, or any part of the body may be contacted by any part of the training partner’s body during training by martial arts techniques, or incidentally contacted while performing a martial arts technique targeting another portion of the body. When male and female students train together, or when adult and minor students train together, and in any other training combination, the purpose and intent of the school, instructors and staff is to provide an environment for all students to learn and practice martial arts and self-defense. Students are expected to conduct themselves appropriately at all times to ensure the best training results for everyone. Should any student feel a training partner is engaging in contact beyond the scope of training, or a training partner is taking undue and unacceptable advantage of training contact, or if a student is made uncomfortable by any training exercise or partner, then that student has the right to withdraw from the exercise or drill. If the conduct of the training partner or any training partner appears criminal, then an instructor should be informed and the authorities may be notified either by the student or the instructor, or both. I Agree CONSENT TO PHYSICAL CONTACT I understand the nature of physical contact in martial arts training, and I understand that I have the right to immediately withdraw from any exercise or drill in which the conduct of any party seems beyond the scope of training or makes me uncomfortable. I agree to abide by school etiquette in all maters pertaining to training, and I shall not in any way conduct myself inappropriately or take inappropriate advantage of the contact martial arts training allows. I Agree MEDIA RELEASE/ WAIVER/ CONSENT I hereby give permission for me and / or my child to be filmed / photographed/ interviewed by the media or representatives of the Dojo during school classes and events and for the Dojo to use my or my child’s photograph / work / voice for promotional and educational purposes. I understand that personal information and the names of minors will never be used. I waive any right to inspect or approve the aforementioned promotional or educational materials used by the Dojo. I hereby release, discharge and agree to hold harmless the Dojo and those acting under its permission from any liability to the extent provided by law for preparation, distribution and use of said materials. I Agree CORONAVIRUS/COVID-19 I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing and other preventative measures. I further acknowledge that The Dojo inc has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19. I further acknowledge that The Dojo inc can not guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, The Dojo inc staff, shareholders, officers of the corporation, employees and owners, and other The Dojo inc clients and their families and I assume all risk. I voluntarily seek services provided by The Dojo inc and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending my appointments, lessons, activities, special events, classes and instruction. I attest that: * I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. * I have not traveled internationally within the last 14 days. * I have not traveled to a highly impacted area of Coronavirus/Covid-19 within the United States of America in the last 14 days. * I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19. * I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non contagious by state or local public health authorities. * I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19. I hereby release and agree to hold The Dojo inc, it’s staff, employees, shareholders, officers of the corporation and owners harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the The Dojo inc, or that may otherwise arise in any way in connection with any services received from The Dojo inc. I understand that this release discharges The Dojo inc from any liability or claim that I, my heirs, or any personal representatives may have against the The Dojo inc with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from The Dojo inc. This liability waiver and release extends to the The Dojo inc together with all owners, officers of the corporation, shareholders, staff and employees of The Dojo inc. I Agree CANCELATION, REFUNDS, RETURNS, TUITION AUTHORIAZATION, POLICIES, TERMS AND CONDITIONS, AND CONSENT TheDOJO, inc. & it’s staff reserves the right to cancel anyone’s membership at anytime for any reason. As a private organization The DOJO, inc. and its staff limits it's enrollment to students who qualify for membership only by the standards and policies set forth by The DOJO, inc.. Upon enrolling at The DOJO, inc. I authorize to charge my credit or debit card provided by me for agreed upon purchases. I understand that my information will be saved to file for future transactions on my account. This authorization will remain in effect until cancelled. I may cancel this authorization at any time by contacting the staff of The DOJO, inc. and I agree to a thirty days written notice of cancellation prior to the next scheduled tuition installment to avoid the cancellation fee in the amount of the next tuition installment. For immediate cancellation within thirty days of the next scheduled tuition installment I agree to pay The DOJO, inc the cancelation fee in the amount of the next tuition installment. Family discounts will return to regular rates from a family discounted rate if a family member cancels their membership. There are No Refunds and No Returns on any merchandise or services. Tuition Rates will be increased to the current rate of tuition at the time, in the event of a the descretion of/by The Dojo inc. it's owners, officers, shareholders employees and not limited to the advancement of new ranks, at the termination of, cancelation or ending of the terms set forth in the membership agreements. I give The Dojo inc permission to contact me through any means such as but not limited to email, phone calls, mail, text messaging/SMS. I Agree INDEMNIFICATION BY PARENTS Applicable only to Parents Enrolling Minor Child I agree not to bring any claim or suit against the, instructors, staff, guests, students, landlord, or any other parties on behalf of my child for any injury or harm sustained by any event short of a criminal act, and then only the criminal shall be the subject of such a claim. I further agree that I will not cause to be brought, nor encourage a claim or suit. I also agree not to cooperate in bring of such a suit or claim except insofar as I may be legally required to do so. Finally, I shall indemnify the school, instructors, staff, guests, students, and any and all additional defendants covered by this agreement for all judgments, costs, attorney fees and other expenses incurred as a result of a breach of this agreement. I Agree ARBITRATION CLAUSE Should any dispute arise between me, my child, or anyone acting on behalf of my child, regarding this school, then I specifically agree that the dispute shall be resolved in binding arbitration. Should a suit be filed in Court, I specifically authorize the court to order the case to binding arbitration. SEVERABILITY If any clause, sentence, phrase or statement is found unenforceable or invalid by any Court of law, the remainder of the document shall remain valid enforceable and the invalid clause, sentence, phrase or statement shall be considered struck from the document. DURABILITY This document is effective from the date signed with no expiration. Furthermore, the terms of this document are retroactive to the beginning of training and visiting the school if this document was signed after that date. I have read this document, and I understand the content of it. I agree to abide by the terms of it. I Agree December 22, 2024 |
