Shihan Franks Karate Academy Karate Training and Body Development

Grading Consent Form And Disclaimer/Waver

SHIHAN FRANKS KARATE ACADEMY

Grading Consent Form And Disclaimer/Waver

This form is copy and paste only; Copy and paste to a word document print, complete and return to the Dojo on training evening.

SURNAME...................................   FIRST NAME...................................

ADDRESS.........................................   SUBURB...................................

POSTCODE...............   PHONE ON ..............................

DATE OF BIRTH.........................   SEX (MALE/FAMALE...........................

PERSON TO BE NOTIFIED IN CASE OF INJURY:

NAME:.......................................    PHONE ON .................................

EXISTING MEDICL CONDITIONS/DISABLTIES

.................................................................................................

Any participants over the age of 30 years or with existing medical or disability, must produce a Medical Certificate "of good Heath"
from a doctor verifying their fitness to participate in martial arts training.

Any participant under the age of 18 must have this from signed by a PARENT or GUARDIAN who is eligible to accept these conditions on their behalf.

DECLARATION

1. I the undersigned, understand that martial arts training can be dangerous and that injuries often result from participation in martial arts training and associated events

2. In consideration of and as a condition of my participation in training or any associated events, for myself, my heirs, executors and administrators, I hereby waive all claims or actions, which I or they might otherwise have, resulting from any loss of life or injury or injury's, damage or loss of any description which I may suffer or sustain in the course of or as result of my participation.

3. This waiver and discharge operates separately in favour of all persons, corporations and bodies involved or otherwise engaged in promoting or staging training or any associated event.

I agree to and accept the above conditions;

NAME..................................................

Signature.............................................    DATE................

Parent's/Guardian/Other Signature (if under 18 )

Date........................

full name (please print) parent/guardian/other;

..................................................

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