FOLSOM KARATE ACADEMY
916 365-3441 Across from the Purple Place
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Events to Register For:
Karate Kid Buddy day
April 14th 10 am - 1pm
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Name of Participant
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Age
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Name of Guardian
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Phone Number
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Which session will you be attending?
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Email
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Please not any special circumstances (Injuries, Handicaps, or allergies)
I (the undersigned) acknowledge that I am aware of the potential risks involved in attending a glow in dark nunchaku seminar. I am fully aware of the potential injuries, and I release the FOLSOM KARATE ACADEMY, its owners, instructors,
assistant instructors, fellow students, and property managers of any liability associated with any injury. I (the undersigned) choose to attend or allow my child to attend the seminar at my own risk.
I also acknowledge that the techniques taught at the seminar are considered safe only under the supervision of a certified black belt instructor. Any use of the techniques without supervision can cause injury. I understand that attending the seminar
does not certify me or my child to use techniques taught without direct supervision of a certified black belt instructor, and any use or practice of techniques taught are done at the risk of the practitioner whether under supervision of a
black belt instructor or not.
I have fully read the above waiver and I agree with its terms.
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