{name} - Full name
{dob} - Date of birth
{address} - Member address
{phone} - Phone number
{contact_name} - Emergency contact (if member has any)
{contact_phone} - Emergency contact phone
{contact_relation} - Emergency contact relation
I, the undersigned, do hereby voluntarily submit my application for attendance and participation into the The Desert Dojo LLC DBA The Desert Dojo school. I, also understand that Martial Arts can be a dangerous and hazardous activity, and do hereby waive all claims against The Desert Dojo LLC DBA The Desert Dojo, it’s owners, agents, employees, heirs, successors, sponsors, officers, instructors, students and members, of all claims for injuries or death that I may sustain or incur while attending or participating in The Desert Dojo LLC DBA The Desert Dojo training program, and all other of it’s school activities.
In the event of any emergency, I hereby authorize any licensed medical personnel to perform any accepted medical procedure deemed necessary and agrees to bear the expense of any such treatment. I have read and understood the above and would like myself or my child to try a lesson and I understand that there are no refunds under any circumstances.
- Name of the member or guardian signing the document (if applicable)
{sign_date} - Date document was signed (if applicable)
The Desert Dojo
