ENROLLING IN VICTORY KARATE/VKfit WITH ERIK AKUTAGAWA:
I, _______________________, being of lawful age of eighteen years, or in the alternative the parent and/or legal guardian for _______________________, a minor under the age of eighteen years, do hereby release and forever discharge and by these presents do for release(s), heirs, executors, administrators, successors, and assigns, release and forever discharge Erik Akutagawa, Victory Karate, VKfit, together with their employees, agents, affiliates, associates, heirs, administrators, executors, successors, and assigns from any and every claim, demand, right or cause of action arising out of or in any way connected to instruction, training, exercise, competition or any other use whatsoever upon the premises described as Del Rey Church, 8505 Saran Drive, Playa Del Rey, California, or any competition or event in which I may register and/or enroll which may be conducted as a corollary to instruction, exercise, training or other use of said facility: the same being a martial arts and workout factiliy for the instruction of American Kenpo style karate and fitness workouts including all injuries, deaths, loss of services and consortium and property damages resulting there from together with any loss of property as might be occassioned through fire, theft, acts of GOD or otherwise.
It is understood that the study of martial arts together with exercise in a facility involves exercise, training, stretching, the practice of techniques and physical confrontation which may occur at a high rate of speed and which may result in actual physical bodily contact between the releasor(s) and their instructors and/or other participants in maritial arts activities. It is therefore also understood and expressly agreed to herein that the martial arts is a sporting event which is entered into by the releasor(s) intelligently, voluntarily and knowingly, and to which the courts have applied the doctrine of primary assumption of the risk within the state of California; said doctrine acting as a complete bar to any recovery as may be sought by a claimant for any injury or damage arising therefrom. [see case of Knight v. Jewett (1992) 3 Cal. rth 296, 11 Cal. Rptr. 2d d, 834 P. 2d 696, and its progeny.] It is therefor understood and expressly agreed to herein by releasor that neither Erik Akutagawa, personally as an individual, nor Victory Karate or VKfit, not their employees, agents, affiliates, associates, heirs, administrators, executors, successors and assigns, may be held responsible for any injury or damage arising from the activities described herein, and further, that if releasor(s) chooses to pursue such a cause of action against those persons release hereunder, that the releasor will indemnify and defend any and all named releasees from any and all damages or injuries or claims or causes of action made, Releasees reserve the right to pursue a cause of action of any monies expended in their own defense as against Releasor(s) including, but not limited to, all court fees, costs of defense and reasonable attorney's fees.
This is a full and final release of any and all claims arising out of the activities described herein having to do with the practice of the martial arts and physical exercise and expressly includes, but is not limited to, all unknown and unanticipated injuries, deaths, loss of services and consortium and damages resulting from said practice of martial arts and physical exercise and/or any casualty or events arising therefrom as well as those now disclosed.
The Releasor(s) will indemnify and save harmless all Releasees from any and every claim or demand of every kind or character which may ever be asserted by reason of any such injuries, illnesses, disease, or the effects or consequences thereof or damages to property or persons as may arise from the use of the subject facilities described herein or the entry in competition or events wherever located.
In executing this Release, Releasors do hereby waive all rights and benefits which they now have or in the future may have under and by virtue the terms of Section 1542 of the California Civil Code which section reads as follows:
"A general release does not extend to the claims which the creditor does not know or suspect to exist in his favor at the time of executing the release which if known by him must have materially affected his settlement with the debtor."
Further, Releasors hereby expressly waive the provisions of the California Code of Civil Procedure 426.10 and 426.30 and by this waiver agree that this Release or any dismissal or any claim with or without prejudice of any action brought by Releasors on accounts of any claim arising out of injury or damage as described herein, shall not release or be a bar to the prosecution of any action now pending or as may in the future be brought against Releasors by any of the persons, firms, corporations or other entities released hereunder.
The General Release in Full of All Claims and Indemnity and Hold Harmless Agreement shall be interpreted, litigated, prosecuted and/or defended in keeping with the laws of the State of California.
THE UNDERSIGNED HAS READ AND UNDERSTANDS THE TERMS AND NATURE OF THE FOREGOING RELEASE AND WARRANTS THAT THIS RELEASE CONTAINS THE "ENTIRE AGREEMENT" BETWEEN THE PARTIES HERETO AND THAT NO PROMISE, INDUCEMENT OR AGREEMENT NOT EXPRESSLY CONTAINED HEREIN HAS BEEN MADE.
Releasors further warrant that they have had ample opportunity to consult with legal counsel and that if not consulting with legal counsel prior to the execution of this Release, have expressly waived the right to do so prior to the execution of this Release.
Furthermore, Releasor(s) promise to uphold the high standards of excellence of Victory Karate/VKfit by always:
Respecting myself and others;
Striving to be the very best I can be;
Presenting & conducting myself in a professional manner;
Being an encouragement to others; and
Promoting the virtues of Victory Karate/VKfit to all.
Releasor(s) grant all rights to Erik Akutagawa, Victory Karate, VKfit, and all Releasees to use, re-use, publish, and republish any comments, statements, or
photographic images, whether written or verbal, intact or in part, composite or distorted, without restriction for
any advertising, promotion, or any other purpose.
IN WITNESS HEREOF, I have hereunto set my hand this ________ day of _________________, 20_____
Signed: _______________________________ Date:_____________
Name (printed): _______________________________
Parent/Guardian signature if under 18: ________________________
Parent/Guardian name (printed): _____________________________
Personal Information:
Name: _____________________________________________________
Address: ___________________________________________________
City: __________________________________ Zip: ________________
Phone: _____________________________
Secondary phone: _____________________________
Email address: _______________________________
Birthdate: __________________
Emergency contact information:
Name: _____________________________________________________
Phone: _____________________________
Secondary phone: _____________________________
Other information:
Occupation: _________________________________________________
Prior training: ________________________________________________
Other interests: _______________________________________________
How did you find out about Victory Karate/VKfit?
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Why are you interested in training with Victory Karate/VKfit? What do you want to accomplish through your training with
Victory Karate/VKfit?
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