Seattle Capoeira Center Liability Waiver

Please read, initial each section, and sign at the bottom.



By signing below, and by participating in one or more of the classes offered at/with Seattle Capoeira Center (SCC) aka Capoeira Angola Palmares of Seattle (CAPS), and Syed Wali Taqi (SWT). I do now release, acquit, and forever discharge SCC/CAPS/SWT, their principals, directors, officers, agents, employees and volunteers [staff] of Seattle Capoeira Center 2909 Rainier Avenue South, Seattle, WA 98144, from all actions, claims, demands, or damages accrued to me resulting from any known or unknown injury, loss, or damage, sustained while participating in SCC/CAPS/SWT functions, classes and/or events.

The parent(s) and/or legal guardian(s) will instruct the minor participant that prior to participating in the below martial arts activity, yoga, dance, samba, event or workshop, he or she should inspect the facilities and equipment to be used, and if he or she believes anything is unsafe, the participant should immediately advise the officials of such condition and refuse to participate. I understand and agree that, if at any time, I feel anything to be UNSAFE; I will immediately take all precautions to avoid the unsafe area and REFUSE TO PARTICIPATE further.

I / We fully understand and hereby acknowledge that A:There are risks and dangers associated with participation in martial arts, yoga, dance, samba, classes, activities and events which could result in bodily injury, partial and/or total disability, paralysis and death. B: The social and economic losses and/or damages, which could result from these risks and dangers described above, could be severe. C: These risks and dangers may be caused by the action, inaction or negligence of the participant or the action, inaction or negligence of others, including, but not limited to, releasees named below. D: There may be other risks not known to us or are not reasonably foreseeable at this time.  

I / We accept and assume such risks and responsibility for the losses and/or damages following such injury, disability, paralysis or death, however caused and wether caused in whole or in part by the negligence of the releasees named below. 

I / We HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE the martial arts facility used by the participant, including it owners, managers, promoters, lessees of premises used to conduct the martial arts event or program, premises and event inspectors, underwriters, consultants and others who give recommendations, directions or instructions to engage in risk evaluation or loss control activities regarding the martial arts facility or events held at such facility and each of them, their directors, officers, agents, employees, all for the purpose herein referred to as Releasee from all liability to the undersigned, my/our personal representatives, assigns, executors, heirs and next to kin for any and all claims, demands, losses or damages and any claims or demands therefore on account of any injury, including but not limited to the death of the participant or damage to property, arising out of or relating to the events(s) caused alleged to be caused in whole or in part by the negligence of the releasee or otherwise.

I / We HEREBY acknowledge that THE ACTIVITIES OF THE EVENT(S) ARE VERY DANGEROUS and involve the risk of serious injury and/or death and/or property damage. Each of THE UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES.

EACH OF 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 law of the Province or State in which the event is conducted and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding continue in full legal force and effect.

On behalf of the participant and individually, the undersigned partners(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 parents(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 understand that I am the best person acquainted with my own physical condition and  limitations. The SCC/CAPS/SWT staff shall be entitled to rely on the representation I provide in my training and classes. I understand that I am practicing a martial art based on focus, respect, and discipline on my own accord, and release the SCC/CAPS/SWT staff from all liability accrued by me during all forms of instruction.

I recognize that the SCC/CAPS/SWT staff, as providers of service, will operate under a covenant of good faith and fair dealing. The staff may find it necessary to terminate an activity due to forces of nature, medical necessities, or other unforeseen problems. I accept these rights SCC/CAPS/SWT may take for my safety.

The acceptance of the agreement above is a waiver of liability on the part of SEATTLE CAPOEIRA CENTER (SCC), CAPOEIRA ANGOLA PALMARES of SEATTLE (CAPS), SYED WALI TAQI (SWT), their principals, directors, officers, agents, employees and volunteers [staff]. This agreement is made for the purpose of preventing any dispute, legal matter, and/or litigation between both parties.

By signing this liability waiver, I will promise to notify the staff of any medical conditions.

May 28, 2020



The SCC website is www.SeattleCapoeiraCenter.com where events and important announcements are. Ensure your email account settings allow emails from seattlecapoeira@gmail.com.  We do not give your personal information to any third parties. Please keep all contact information current as we communicate with our students electronically.

Hours and Scheduled Closures

The SCC is open with the exception of most Federal Holidays, additional times for summer, and winter break. Information on closures and revised hours of business are available at the calendar portion of the website. The front desk can be reached at (206) 372-2691 or by at seattlecapoeira@gmail.com.  Always check the calendar

Ground Rules and Code of Conduct 

The SCC is located at the Mt. Baker Lofts with Syed Taqi being a current resident. Members or member guests are considered a house guest of Syed Taqi at the Mt. Baker Lofts. It is required to act in a respectful manner to all residents and neighbors. There is no smoking or consumption of alcoholic beverage. Please keep the area clean- do not leave personal items unattended in the lobby and do not wander on the grounds. Do not sing and dance after 9:45pm. See the attached document for the official guidelines for Seattle Capoeira Center.

Use of Facility

The SCC is a no shoes facility. Please keep our space clean and better than before you came. We also have a community room available for workshops and special events. The community room is for registered students\guests of Syed Taqi during scheduled class hours for public group training.  Additional private lessons must be scheduled through the staff. Usage of the center and community room is prohibited without a designated teacher present.

Ongoing Agreements

The SCC has various contract agreements to choose from.  Your monthly tuition reserves your space as a member of the SCC.  A student may withdraw from lessons at any time for any reason with a month to month contract.  However, students are expected to make monthly tuition payments until withdrawing from lessons by submitting a written 30 day notice from their final tuition payment.

All 3 month, 6 month and 12 month contracts and membership terms must be completed. All class cards expire after 90 days from purchase. 

Once a student has withdrawn from lessons, there will be a $35.00 re-registration fee to re-enroll students. In the event that a student is seriously ill or injured, freezing their agreement and tuition can be negotiated with staff. A physician's note will be required for documentation to freeze the contract agreement. Missing or not showing up for scheduled lessons does not constitute notice of withdrawal from lessons. Absolutely no refunds for all tuition payments. Regular attendance is essential for success.

Guests and Trial Classes  

Most of our membership is through community outreach and referrals from students. Students are welcome to bring a guest who is interested in joining the SCC. Guests will receive 1 complimentary trial class when attending with a registered member. 

Photo/Video Release

The WCC is hereby granted permission to take photographs and videos of you and the students to use in media advertising, posters, and other promotional materials. 


Mindbody collects all tuition for the Seattle Capoeira Center classes and lessons. All tuition payments are non-refundable. Contact the staff to inquire on freezing tuition to due to serious injury or medical conditions. All questions about tuition payment processing should be directed to seattlecapoeira@gmail.com. 

Delinquent Payments

Students are expected to keep all tuition payments current. Payments more than 5 days late will be charged a $10.00 late fee. Payments more than 30 days late will incur an additional $25.00 late fee.  Payments more than 60 days late will be sent to collections. Late payments or the failure to make tuition payments does not constitute withdrawal from classes or cancellation of an ongoing contract agreement.


Members are required to purchase a uniform after the first week of class. Uniform prices vary based on size and type.

Scheduled Performances and Capoeira Rodas

Seattle Capoeira Center sponsors monthly Capoeira Angola Rodas as part of the SCC's contribution to the history, culture and community of Capoeira which are free to members. Participating in Rodas is a fun and challenging part of playing Capoeira Angola. Students are encouraged to participate in SCC Rodas, but are not required to perform.  

Class Cancellations

In the unlikely event that the Seattle Capoeira Center is closed due to inclement weather, or any other unforeseen reason, the closure will be posted on the SCC's website and/or posted on the door. See the staff about make up days and open practice.

Substitute Teachers

Seattle Capoeira Center reserves the right to provide a substitute teacher in the event that the regular teacher is ill or unavailable. If an appropriate substitute teacher is not available, class may be cancelled and an open practice will be made available.


By signing this form, I agree to the terms and conditions listed above.

I Agree



First Participant's Name

First Name*

Middle Name

Last Name*

First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

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Second Participant's Date of Birth*
Third Participant's Name

First Name*

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Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

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Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

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Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

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Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

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Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

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Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address


Confirm Email*
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Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*


Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.

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