Fill out 1 form for each Girl participating

I understand that the training, instruction, and/or lessons which I have registered for and will receive at Karate TN DBA Ultimate Success Karate (USK) involve strenuous physical activity and physical contact with the instructors and students (USK). These activities may be hazardous and may result in personal injury.  The person and guardian (if applicable) whose signature appears below states that he or she has no knowledge of any physical condition that would render these activities dangerous and/or hazardous to his or her health, or the health of his or her ward (if applicable). I promise to notify Ultimate Success instructors immediately, in writing and delivered in person to an instructor of (USK), before the next lesson to be received, if any such condition should develop.  After review of the written notification, Ultimate Success reserves the right to terminate instruction if the review warrants such action. 

Additionally, (USK) urges all members to obtain a physical examination from his or her physician prior to the attendance of any exercise program, or use of any equipment at the Ultimate Success. 

The enrolled member recognizes that they are enrolling in a martial arts facility and that (USK) will provide a place of instruction for all classes and practice sessions as well as qualified instructors for these classes.  We take reasonable care to prevent accidents and to minimize injuries.  We require that the students obey the rules and regulations of the school.  No member shall practice free sparring or self-defense techniques without a qualified instructor present. 

Additionally, he/she may be photographed or filmed while attending at the premises of (USK) and he/she gives permission to (USK), and any affiliates to use any and all photos, video footage, and/or video streaming for promotional, sales, publicity, and advertising purposes for all media including internet. 

In recognition, the person and guardian (if applicable) whose signature appears below, with full personal knowledge, voluntarily waives any right or cause of action of any kind, both individually and for their heirs, executors, administrators and successors, arising as a result of taking martial arts lessons at (USK), and from any competitions that they may enter as a student of (USK), which any liability may or could be assigned to (USK), its instructors, employees, officers and administrators.