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Adult Karate (13+)

Duration 08/01 - 12/31
Access 5 sessions
Cost $65.00 / month + $25.00 signup fee
Programs All Programs
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Youth Karate (6-12)

Duration 08/01 - 12/31
Access 5 sessions
Cost $65.00 / month + $25.00 signup fee
Programs All Programs

Membership Documents

Waiver / liability release

RELEASE OF WAIVER AND LIABILITY AND INDEMNITY AGREEMENT
Cortland KarateDoGaku, Inc. d/b/a Cortland Kori-Kan

Participant Name: {name}
Date of Birth: {dob}

PLEASE READ CAREFULLY. THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS AND IS LEGALLY BINDING. BY SIGNING THIS AGREEMENT YOU ARE RELEASING CORTLAND KARATEDOGAKU FROM ALL LIABILITY AND FOREVER GIVING UP ANY CLAIMS THEREFORE.

In consideration of being allowed to participate in martial arts instruction, training, events, and other related activities (“Programs”) offered by Cortland KarateDoGaku, Inc. d/b/a Cortland Koei-Kan (“Dojo”) at any location used by the Dojo (“Facilities”), I, the undersigned, acknowledge and agree as follows:

1. I/WE agree that prior to participating in the below Programs activity or event, I/WE shall 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.

2. I/WE fully understand and acknowledge that:

(a) There are risks and dangers associated with participation in our Programs 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, the Releasees named below.

(d) There may be other risks not known to us or are not reasonably foreseeable at his time.

3. 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 whether caused in whole or in part by the negligence of the Releasees named below.

4. I/WE HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE the Dojo or facilities used by the participant, including its 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 dojo facility or events held at such facility and each of them, their directors, officers, agents, employees, all for the purposes 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 EVENT(S) CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEE OR OTHERWISE.

5. I/WE HEREBY acknowledge that THE ACTIVITIES OF THE PROGRAM (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.

6. 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 State of New York and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding continue in full legal force and effect.

7. On behalf of the participant and individually, the undersigned partner(s) and/or legal guardian(s) for the minor participant executes this Waiver and Release. If, despite this release, the participant makes a claim against any of the Releasees, the parent(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 HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

Participant: {name}

Signer Name:
Student (if 18 or older) or Parent/Guardian (if under 18)

Date: {sign_date}

Done Clear Sign Below:

Signature

Guardian Signature

Guardian Name

Photo, Video, and Social Media Release Form

Participant Name:{name}

Date of Birth (if minor): {dob}

I hereby grant permission to Cortland KarateDoGaku, Inc. d/b/a Cortland Koei-Kan (hereafter, “the Dojo”) and its representatives, employees, volunteers, successors, and assigns to take photographs, video recordings, and/or audio recordings of me or my minor child during classes, events, or other dojo-related activities.

I further grant the Dojo the right to use, reproduce, publish, and display such images, videos, and recordings in whole or in part—without compensation—for purposes including, but not limited to:

Social media posts (e.g., Facebook, Instagram, YouTube)

Promotional materials

Website and newsletters

Press releases and advertising

I understand that the Dojo will not identify minors by full name without explicit additional consent. I waive any right to inspect or approve the finished materials and release the Dojo from any claims, demands, or liabilities arising out of or related to the use of these materials.

Opt-Out Option

If you do not wish to have you or your child included in any photo, video, or social media content, please check the box below:

I do NOT grant permission to use photos or videos of myself/my child for promotional purposes.

Participant or Parent/Guardian:
Date: {date}

Done Clear Sign Below:

Signature

Guardian Signature

Guardian Name

RELEASE OF LIABILITY - READ BEFORE SIGNING
A.K. Community, LLC as Virgil Community Center

In consideration of being allowed to participate in any way owned by A. K. Community, LLC hereby referred to as the Virgil Community Living Center its programs, related events, and activities, the undersigned acknowledges, appreciates, and agrees that:

1.              The risk of injury from the activities in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist;

2.             I, THE UNDERSIGNED, KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and

unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE THE RELEASE or others, and assume full responsibility for my participation; and

3.             I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and

4.             I, for myself and on behalf of my heirs assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS VIRGIL COMMUNITY LIVING CENTER, its officers, officials agents and/oremployees, other participants, sponsoring agencies, sponsors, advertises and, if applicable, owners and lessors of permission used to conduct the event ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCEOF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP ALL SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT .

Print Name: {name}

Date: {sign_date}

Signer's Name:

Done Clear Sign Below:

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Adult Karate (13+)

Youth Karate (6-12)

Membership Documents

Waiver / liability release

Opt-Out Option

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP ALL SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT .

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