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  AUSKF AGREEMENT AND RELEASE FROM LIABILITY

1. Voluntary Participation.  I, , acknowledge that I have 

{name}

voluntarily applied, or have voluntarily allowed my child  to apply, to

{name}

participate in kendo instruction and training at a dojo or club which is affiliated with  the All United States Kendo Federation (hereinafter, any and all affiliated dojos or clubs are referred to as “AUSKF”).

2. Assumption of Risk.  I AM AWARE THAT PARTICIPATION IN KENDO/IAIDO/JODO, AS IN ANY SPORT OR PHYSICAL ACTIVITY, MAY CAUSE PHYSICAL INJURY, DAMAGE TO PROPERTY, AND, IN RARE INSTANCES, EVEN DEATH.  I AM VOLUNTARILY PARTICIPATING, OR ALLOWING MY CHILD TO PARTICIPATE, IN THIS ACTIVITY WITH KNOWLEDGE OF THE DANGER INVOLVED, HEREBY AGREE TO ACCEPT ANY AND ALL RISKS OF INJURY, DAMAGE, AND/OR DEATH, AND VERIFY THIS STATEMENT BY PLACING MY INITIALS HERE.  .

3. Release.  As consideration for being permitted by AUSKF to participate in these activities and use related facilities, I hereby agree that I, my assignees, heirs, distributees, guardians, and legal representatives will not make a claim against, sue, or attack the property of AUSKF, SWKIF, ZenBuKan, the First Baptist Church of Salt Lake, and the City of Salt Lake on account of injury, damage, or death resulting from the negligence or other acts, however caused, by any employee, agent, or contractor of AUSKF as a result of my, or my child’s, participation in kendo/iaido/jodo.  I hereby release AUSKF from all actions, claims, or demands that I, my assignees, heirs, distributees, guardians, and legal representatives now have or may hereafter have for injury, damage or death resulting from my, or my child’s, participation in kendo/iaido/jodo.

4. Knowing and Voluntary Execution.  I HAVE CAREFULLY READ THIS RELEASE AND FULLY UNDERSTAND ITS CONTENTS.  I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN AUSKF AND ME AND SIGN IT OF MY OWN FREE WILL.

Executed on {sign_date} _________________at [city]___________________, [state]________.

______________________

Signature of participant or, if participant is a minor, 

signature of participant’s parent or guardian

{name}_ ________________________________________

Print name

DECLARATION OF WITNESS

I certify that {name}______  [above participant/parent of participant] acknowledged in my presence that he/she read and fully understood the meaning and consequences of the above release, and signed it in my presence.

Executed on {sign_date} _________________at [city] ___________________, [state] ________.

_________________________________________

Signature of witness

_________________________________________

Print name

Zen Bu Kan Waiver

Name of Participant  {name}

Date of birth {dob}

Address {address}

Phone Number {phone}

Emergency Contact {contact_name}

Emergency Contact Relation {contact_relation}

Emergency Contact Phone {contact_phone}

  Statement of Agreement – Assumption of Rick, Liability Release and Refund Policy

1. Assumption of Risk: I hereby acknowledge and agree that my own or my child’s participation in the martial arts training and practice of kendo, iaido, or jodo involves inherent foreseeable and unforeseeable ricks and hazards which may expose my child, or me, to illness, injury, or death. In consideration of mine or my child’s participation in such activities, I for myself, my child, my heirs, my executors and administrators, freely and voluntarily agree to assume and accept any and all risks to my child or myself associated with mine or my child’s participation in all activities associated with Zen Bu Kan and the martial arts training provided as a part of kendo, iaido, and jodo.
2. Release: In consideration of mine or my child’s participation in the Zen Bu Kan martial training activities, I, for myself, my child, my heirs, my executors and administrators hereby release Zen Bu Kan and its officers, agents, and employees from any cause of action, claim, or demand of any nature whatsoever I or my child may now have, or have in the future, against Zen Bu Kan on account of personal injury, property damage, death, or accident of any kind, caused by, arising out of, or in any way related to my child’s participation in Zen Bu Kan training and practice activities.
3. Indemnification: In consideration of mine or my child’s participation in the Zen Bu Kan martial activities, I agree to indemnify and hold harmless Zen Bu Kan, its officers, agents and employees from any and all causes of action, claims, demands, losses, or costs of any nature whatever cause by, arising out of, or in any way related to my child’s participation the Zen Bu Kan martial training and practice activities. I agree that my duty to defend and indemnify Zen Bu Kan under this Agreement includes all attorney fees, litigation and court costs, expert witness fees, and any sums expended by or assessed against Zen Bu Kan for the defense of any claim or to satisfy any settlement, arbitration award, or verdict paid or incurred on behalf of Zen Bu Kan arising out of or in any way related to mine or my child’s participation in the Zen Bu Kan activities.
4. Refund: Refunds may only be requested in person and must be accompanied by a written request. Refund of payments received will be solely at the discretion of Zen Bu Kan head instructors. Membership in Zen Bu Kan is a membership fee, not an attendance fee. Refunds are not given for months or time periods of non-attendance.
5. Membership in Zen Bu Kan may be revoked at any time at the discretion of Zen Bu Kan head instructors for matters of significant safety violations, repeated minor safety violations, severe or repeated breach in personal conduct protocol, or repeat violations of Zen Bu Kan general rules. Failure to remain up to date on membership fees, may constitute grounds for dismissal at discretion of Zen Bu Kan head instructors. However, individuals with hardship conditions may speak with the head instructors privately for additional consideration.   
6. Emergency Treatment: I hereby authorize Zen Bu Kan instructors to act on my behalf in accordance with their best judgment in case of an emergency involving myself or my child, and agree to assume full responsibility for all expenses, medical or otherwise, that may arise therefrom.
7. Media Consent: I hereby grant permission to Zen Bu Kan to use mine or my children’s photograph, videotaped image, quotes/comments, or name for publicity and educational purposes in any and all publications and media without limit or compensation.
8. Name Posting: Unless otherwise indicated below, Zen Bu Kan is authorized to post or publish the name of my child participating in Salt Lake County recreational activities on the Salt Lake County website.

        I do not authorize Salt Lake County to post or publish the name of my child participating in Salt Lake County recreational activities on the Salt Lake County website.

By signing this assumption of risk, liability release, and refund policy statement, I acknowledge that I have read its contents and disclosure, that I understand its contents and disclosure and that I agree to its terms. If any portion of this Agreement is held to be invalid by a court of law, then it is agreed and intended that all the remainder shall, notwithstanding, continue in full force and effect.

       Signature:  

       Name: {name}

       Date: {sign_date}