Student Name *

Please complete and sign this form prior to participating in classes or fitness programming at ‘Ohana Martial Arts. Completed forms must be submitted online. We are eliminating paper form by 2020.

First Name

Last Name

Phone *

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Secondary Emergency number *

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Would you like to receive emails about future dojo happenings? *

Yes

No

I already get emails

Permission to use images of your student 'Ohana Martial Arts is authorized by to use video or photographs of you student for advertising, publicity and public relations. Video-footage will only be used by 'Ohana Martial Arts Non-profit Self-defense School. No further claims may be made. If there is a court ordered safety issue with use of photos/videos such as foster children please let us know in advance.

Agree

Discipline is used to insure safety for all staff and students All children are expected to respect themselves others and all property. Time out from activities will be enforced if a student is acting unsafe If consistent behavior problems are interrupting programing or endangering students parents and/or guardians will be contacted to remove student from program Ohana Martial Arts Nonprofit Self Defense School reserves the right to refuse any student from future programming. I give Ohana Martial Arts Nonprofit Self Defense School the authority to exercise these discipline policies in regard to my student. *

Agree

Full Responsibility Waiver I, _____________________________, take sole responsibility for any personal injury I (or my participating family members) may incur over the course of any and all 'Ohana Martial Arts programs we may participate in. I acknowledge that participation in this program exposes me to potential risks and I release all instructors or fitness coaches from any and all liabilities regarding an injury and will cover all medical costs associated with injuries from participation. I shall not now or in the future prosecute any lawsuit against 'Ohana Martial Arts non-profit self-defense school or its directors, board of directors or instructors. I’m aware that this agreement will be legally binding. I have read and understood this Injury Waiver and Medical Release Form as a participant or a parent/guardian. *

Agree

I understand that there are risks in attending camp and me or my family may be inadvertently exposed to illness, including COVID. ‘Ohana Martial Arts follows all laws and regulations and should Kona have widespread community spread of any illness or virus, this class may close for the protection of the participants and community. I release 'Ohana Martial Arts, all instructors or fitness coaches from any and all liabilities regarding illness, closures and will cover all medical costs associated with illness from participation. I shall not now or in the future prosecute any lawsuit against 'Ohana Martial Arts non-profit self-defense school or its directors, board of directors or instructors. Students and staff with active cold symptoms are not allowed at class. We will safely isolate participants with new symptoms until you come to pick them up. Parents are expected to be available or have an appointed adult able to come pick up sick students. *

Agree