Easy
PDF version of
student application:
FRONT PAGE
BACK PAGE

BUSHIDO-KAI Application
General Information
Last Name: First Name: Middle Initial:
Street Address:
Town: State: Zip:
Home Phone: Work Phone:
Birthday: Age: Sex:

Style Name: Your Rank: Instructor: His/Her Rank:
Style Name: Your Rank: Instructor: His/Her Rank:
Style Name: Your Rank: Instructor: His/Her Rank:
Style Name: Your Rank: Instructor: His/Her Rank:
Style Name: Your Rank: Instructor: His/Her Rank:
Approximately how many years have you studied the martial arts?

ALL APPLICANTS must complete SECTION (A), if an adult, OR have a parent/guardian complete, if a minor.


Section A: Waiver for applicants 18 years old or older

BUSHIDO-KAI ENTRANCE PLEDGE:
I shall endeavor to the best of my ability to SEEK PERFECTION OF CHARACTER, STUDY FAITHFULLY, ENDEAVOUR with full physical effort and mental concentration, RESPECT OTHERS and practice courtesy, and REFRAIN FROM VIOLENT ACTION unless absolutely necessary in self-defense.

Date: _____________________ Legal signature: ________________________________

WAIVER AND RELEASE OF LIABILITY
In consideration of being allowed to participate in any way in BUSHIDO-KAI martial arts training, the undersigned:
A. Agrees that prior to participating, he/she will inspect the facilities and equipment to be used, and if he/she believes anything to be unsafe, he/she will immediately advise the supervisor of such condition(s) and refuse to participate.
B. Acknowledges and fully understands that the participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses that might result from their own actions, inaction, or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to or is not reasonably foreseen at this time.
C. Assumes all the foregoing risks and accepts personal responsibility for the damages following such injury, permanent disability or death.
D. Releases, waives, discharges and covenants not to sue BUSHIDO-KAI, its affiliated clubs, respective administrators, directors, agents, teachers, and other employees of the organization, other participants, sponsoring agencies, sponsors, advertisers and, if applicable, owners and lessors of premises used to conduct the event.
I HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT VOLUNTARILY.

Signature of Participant (Parent if under 18) ____________________________________ Date_________________________

Printed Name of Participant ___________________________________________


New Student Survey
Occupation:
Talents, hobbies, and past-times:


Would you be interested in occasionally volunteering your services in the above categories to help develop BUSHIDO-KAI?
HOW did you find out about BUSHIDO-KAI?


Why are you interested in Martial Arts?


How long do you plan to study Martial Arts?


 


Aiki-ju-jutsu (the root of Aikido) /  Karate (Karate-jutsu) / Seiken Budo / Martial Arts DVDS
Martial Arts Books
/  Classes /   Seminars

 
Images and content copyright Bushido-Kai.net — All Rights Reserved | Site design by WadeInCreativity