After-School Martial Arts Program

1. I ________________ UNDERSTAND THAT Double Dragon Goju-Ryu Karate-do Organization, LLC (“DDGRKO”) IS A MARTIAL ARTS SCHOOL AND NOT A DAYCARE IN AS SUCH, THEIR STOCK‐IN‐TRADE IS NOT SUPERVISION AND CARE. DDGRKO INTENDS TO TEACH MARTIAL ARTS, PHYSICAL, AND PROPER ETIQUETTE SKILLS.  

2. I ________________  UNDERSTAND THAT DDGRKO IS A MARTIAL ARTS SCHOOL AND IS AN OPEN-ACCESS FACILITY. IN AS SUCH, MY CHILD(REN) IS/ARE FREE TO COME AND GO, AND IF MY CHILD(REN) IS TO STAY AT THEIR FACILITY, IT IS BECAUSE OF MY DIRECTION AND NOT THE DDGRKO. THERE ARE NO EXPECTATIONS OF CHILD CARE

2. Confidentiality Clause: DDGRKO will not release this personal and private information to any third party for purposes of sales, advertising or other reasons.

3. Waiver & Release: I understand that all reasonable precautions are taken to ensure that the martial arts programs and activities at DDGRKO are conducted by mature and qualified personnel safely and responsibly. However, I further understand that, due to the nature of some activities within the Martial Arts program, there is a potential for accidental injury. I acknowledge these risks and agree to allow my child to participate in the martial arts program. I agree to assume these risks and waive any claim against DDGRKO and its employees or agents as to any injury that may occur to my child/children. I have carefully read the entire document and fully understand and agree to comply with every detail, including tuition and any conditions for dismissal. I also grant DDGRKO the right to use any individual or group photographs of my child/children taken in the Academy’s activities for publication and advertising purposes.

4. LOSS/DAMAGE/THEFT OF STUDENT’S PROPERTY: The Academy does not assume any responsibility for the loss, damage, or theft of any belongings of the Student and the Student agrees that the Academy and its personnel are not responsible for, or liable for, any such property even if its loss, damage, or theft occurs in or about the Academy’s facility.

Payments must be made by Friday, whether the student attends class or not. No refunds, No Prorates, and No rollover credits will be issued for unused time. Late pick‐up penalty $10.00, Late payment penalty $20.00, Failure to notify of Absence $20.00

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NEW STUDENT CHECKLIST

Please Initial Each of the Following:

I have signed the “After-School Registration Form” and understand and agree to its terms.

___I understand that my child’s class will be from 4:00 pm to 5 pm

___I understand that, by law, my child may not stay at the facility for longer than four (4) hours and will pick my child up accordingly (65C-22008).

I understand that late pickup will incur a $10 late fee and that consistent tardiness can be grounds for termination of my contract with Double Dragon Goju-Ryu Karate Organization (DDGRKO).

___I have no expectation of childcare at this facility and am allowing my child’s attendance solely for the purpose of martial arts instruction. I have notified my child’s school that DDGRKO will be picking my child up and have made all necessary arrangements.

___I have read and understand Florida Code 65C-22.008 (a copy can be found in the school office) concerning Child Care.

___I understand that DDGRKO falls under the exemption listed in “subsection (3)” and I know the rules by which DDGRKO abides.

___I have no expectation of childcare. I, the undersigned, have read, understand, and agree to each of the conditions listed above.

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DOUBLE DRAGON KARATE INSTITUTE

Release, Waiver of Liability and Indemnity Agreement

In consideration of being permitted to participate in any way in a Martial Arts competition, and/or any training therefor (collectively, “martial arts activity or event”), the parent(s) and/or legal guardian(s) of the minor participant named below (“Participant”) agree: The parent(s) and/or legal guardian(s) will instruct the Participant that before participating in the martial arts activity or event, the Participant should inspect the facilities and equipment to be used, and if Participant believes anything is unsafe, Participant should immediately advise his or her Grand Master and the officials, as applicable, 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 ensure that Participant REFUSES TO PARTICIPATE further.

1. I/We fully understand and acknowledge that:

A. The martial arts activity or event imply that one may be taught and may practice techniques for physical self-defense but not limited to a variety of movements which include defensive blocks and offensive strikes primarily using the hands and feet; and, as one progresses, the techniques taught and practiced become more complex and physically demanding; and, one may also engage in sparring which involves physical contact with others; and, based on all of the foregoing, there is a danger that one may suffer bruises or other sorts of physical injuries

B. There are risks and dangers associated with participation in martial arts events and activities, which could result in bodily injury, including, without limitation, partial and/or total disability, paralysis, and death. Such bodily injuries can consist of concussions and injuries to the teeth and jaw.

C. The social and economic losses and/or damages, which could result from these risks and dangers described above, could be severe.

D. These risks and dangers may be caused by the action, inaction, or negligence of Participant or the action, inaction, or negligence of others, including, but not limited to, the Releasees named below.

E. There may be other risks not known to us or not reasonably foreseeable at this time.

F. I/We will ensure that the participant wears the whole World Karate Federation (WTF) approved sparring gear at all times while participating in any martial arts activity or event. Such gear includes headgear, mouthguards, chest protectors, groin protection, and protection for the hands, arms, legs, and shins.

2. I/We accept and assume on behalf of Participants risks and responsibility for the losses and/or damages following such injury, disability, paralysis or death, however caused and whether caused in whole or in part by the negligence of the Releasees (defined below).

3. I/We HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE Double Dragon Goju-Ryu Karate-do Organization, LLC, and its managers, members, employees, contractors, representatives, agents, promoters, lessees of premises used to conduct the martial arts event or program, premises and event inspectors, underwriters, consultants and others who give recommendations, direction or instructions to engage in risk evaluation or loss control activities regarding the martial arts facility of events held at such facility and each of them, their directors, officers, agents, employees(collectively, the Releasees”) from and against any and all claims, demands, losses, liabilities, damages and expenses of the undersigned and Participant, and any claims or demands therefor on account of any injury, including, without limitation, death of Participant, or any property damage, arising out of or relating to the event(s) caused alleged to be caused in whole or in part by the negligence of any Releasee or otherwise.

4. 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.

5. EACH OF THE UNDERSIGNED further expressly agrees that this Release, Waiver of Liability and Indemnity Agreement is intended to be as broad and inclusive as is permitted by the law of the providence or state in which the martial arts activity or event is conducted and that if any portion is held invalid, it is agree that the balance shall, notwithstanding continue in full legal force and effect.

6. The undersigned parent(s) and/or legal guardian(s) of Participant execute this Release, Waiver of Liability and Indemnity Agreement individually and on behalf of Participant. If, despite the waiver and release hereunder, the participant makes a claim against any of the Releasees, the parent(s) and/or legal guardian(s) will indemnify such Releasee and hold them harmless for any liabilities, losses, or expenses incurred by such Releasee as a result thereof.

7. Attendance at or participation in classes and other events, seminars and training activities constitutes an agreement by the Participant to allow use and distribution (both now and in the future) of Participant’s image or voice in photographs, videotapes, electronic reproductions, or audiotapes of such classes and other events, seminars, and training activities. I/WE HAVE READ THIS RELEASE, WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I/WE HAVE GIVEN UP SUBSTANTIAL RIGHTS INDIVIDUALLY ON BEHALF OF PARTICPANT BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME/US AND INTEND MY/OUR SIGNATURE(S) TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

Name of Participant:                                                Date:

Parent/Legal Guardian:                                           Parent/Legal Guardian