01/05/2024
The dojo is going through a transition from the Clarksville Dojo to the Highland Dojo. No change except for the legal entity.
Unfortunately, this will require a new release which is attached.
My apologies if you have already sent me one.
Best regards,
art
Training Agreement and Liability Release
I hereby represent that I am physically and emotionally fit to engage in martial arts instruction. I have been allowed to ask questions and discuss concerns about this training. I further acknowledge that by entering upon the course of martial arts training, that I will be exposed to a risk of personal injury arising out of possible negligence or unavoidable accident due to the very nature of the physical arts of self-protection. By signing this agreement it is my stated intention to knowingly assume such risk and to hold Charles Collins, Paul Masse, Anthony Tony Meoni, Highland Dojo LLC, and Clarksville Dojo, LLC, all authorized instructors, students, training facility and all agents and representatives thereof completely free of liability for any injury and/or death sustained as a result of my participation in martial arts instruction and training. (Initial )
I hereby release Charles Collins, Paul Masse, Tony Meoni, Clarksville Dojo and all agents or members of said organizations from any losses, injuries, liability or damage of any kind whatsoever, including, but not limited to, court costs, and attorney fees, arising out of the use of facilities, instruction or services provided. (Initial )
I warrant and guarantee that I am or my parent or guardian is/are responsible for my health and medical care which coverage shall extend to any injuries sustained while participating in the subject matter of this agreement. My heirs, executors, administrators, successors, and assigns are intended to be bound by the terms of this agreement. (Initial )
In the event of an emergency, I hereby authorize transportation and licensed personnel to perform any accepted medical procedures deemed necessary or advisable and agree to bear the expense of any such transportation and procedures. (Initial )
I shall conduct myself at all training sessions in such a manner as to avoid committing any acts that would willfully cause other training participants or instructors to be subject to the danger of possible harm or injury. If my conduct, actions or statements are determined by instructor to be detrimental, then I shall willingly comply with the request of the instructor and if necessary remove myself from the training area. I will forfeit any and all prepaid training fees if requested to terminate my training. (Initial )
By my signature below, I warrant that I have read, understand and will voluntarily comply with the terms of the Training Agreement and Liability Release.
Name:
Address:
Telephone (cell): email:
