Sunday, 6 July 2008

Class Students indemnity Form

Participant Application and Indemnity

Name; _______________________________________________
Address; _________________________________________________________
Tel; _________________________ Email; _________________________________
Please read carefully
Wild Lotus classes, seminars, workshops (Aikido, Tai Chi, Yoga, Massage, Sumie) ; are arts with certain principles, traditions which have to be understood and observed at all times. Any physical activity and eastern art has an element of danger and unpredictability in its practice so permanent and serious injury could possibly result from your participation in this practice you are participating in with Wild Lotus Arts. For this reason we ask you to carefully read the indemnity below and indicate your assent to signing your name. Participants under the age of 18 years must have a parent of guardian sign to indicate their consent.
To be completed by participant
I,_______________________________________(name), the undersigned, of the above address, hereby recognize that this activity/ class I involve myself in could by its nature produce serious and permanent injury. I realise that I should I sustain any injury, no matter how caused, through participation in the classes/workshops, no liability, neither tortuous nor contractual, will attach to any of the instructors of or participants in the said seminar/class/workshop;
I have the following illness, disability or injury that could place me at risk of injury during training; ________________________________________________________
Notwithstanding such injury(s), I agree to assume the risk of such injury(s) being aggravated and indemnify the instructors of, and the participants in, the said seminar/class/workshop of any liability with respect to this or any other injury I may sustain no matter how caused. I realise a serious and disciplined attitude is required at all times to minimise the risk of injury.
I agree to pay for any property damage to the venue owner if I damage and of the property willingly or unintentionally, including carpet, funrniture, buildings.

Signature of participant; __________________________ Date; ___________________

Signature of parent of guardian; ____________________________
(Sign if participant is under 18 years)