Karate Warriors Canada

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Registration Form

Location *

Student FULL Name: *

Student Gender *

Male

Female

Other:

Student Date of Birth: *

YYYY

Primary parent FULL name and relation to student *

Primary Parent Phone# *

Primary Parent Email ID: *

Full Home Address: *

Health questionnaires: *

Has your doctor ever said that you have a heart condition and that you should only do physical activity that is/are

Do you feel pain in your chest when you are doing any physical activity?

Do you too often lose your balance because of dizziness or do you ever lose consciousness?

Do you have a bone or joint problem that could be made worse by a change in your physical activity?

Are you currently taking prescription drugs for blood pressure or heart condition?

Do you know of any other reason why you should not do physical activity?

NOT APPLICABLE

Required

Medical Information: *

Heart Ailment

Hernia

Epilepsy

Required

Any other medical condition that you think to be declared? (if no, mention NOT Applicable or NA) *

CODE OF CONDUCT:

1. Student (all Ranks) to follow Karate Warriors Canada rules and regulations always and anytime

2. Students are not to change practice style during the course

3. Any change or moderation in practice will lead is suspension of from Karate Warriors Canada

4. Participating in any external events without formal written approval from Karate Warriors Canada lead to suspension of the membership

5. Student is not allowed to train or conduct classes in or outside the dojo by their own without approval from Karate Warriors Canada

6. Karate Warriors Canada reserves exclusive right to suspend or terminate student in violation to above code of conduct.

7. Karate Warriors Canada reserves exclusive right to change, remove, update the program, and fees

8. Elite Athletes are need sanction from Karate Warriors Canada, before switching the club as Karate Ontario by laws.

I accept as a students or a legal guardian of a minor student(s)

Required

Personal Information Protection and Electronic Document Act (PIPEDA) Release and Agreement.

Consent: I give consent to collect my personal information for the purpose of registration and continuation of the program under Karate Warriors.
Collection and Use: Collect personal information only for appropriate purposes, such as enrollment, communication, and administration of the karate school. Limit the collection and use of personal information to what is necessary for these purposes.
Third-Party Disclosure: We don't share your personal information to third parties, unless it falls under a PIPEDA exception.
Training and Awareness: Please be ensure that our staff and instructors are aware of their obligations under PIPEDA and provide appropriate training on privacy practices and data protection.
Retention and Disposal: Your information is retain for 2 years from the termination from our program and will be dispose securely once it is no longer needed for its intended purpose.

*

I give my consent as a legal guardian of the participant.

WAIVER AND RELEASE OF LIABILITY:

In consideration to participate or of being allow to participate in any way in Karate Warriors Canada program, related to events, classes, and activities, I acknowledge and give my consent to below list of risk, but not limited to:

1. The risk of injury from the activities involved in this program can be high, including the potential for permanent paralysis and life threatening. While following club rules, safety gears, and personal discipline may reduce the risk, the risk still exist.

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISK, both known and unknown, EVEN IF ARISING FROM THE ERROR OR POSSIBLE OFF-SIGHT

3. Any incident and injury out side the club premise is out of the scope for Karate Warriors Canada jurisdiction

4. Injury in sparing is very common in any martial art form. I understand and assume the risk of any injury during sparing.

5. I willingly agree to comply with the stated and customary terms and conditions for participation. If however I observe any unusual significant hazard during my presence or participation, I will remove myself from the participation and bring such attention to the Karate Warriors officials immediately

6. I, for myself and on behalf of my heirs, and assigns, personal representatives and next of kin, HEREBY RELESE AND HOLD HARMLESS Karate Warriors Inc. and their officers, coaches, assistant coaches, employees, business partners, share holders, sponsors, advertisers, lessors of the premises WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage of to person, property of any kind, WHETHER CAUSED BY THE NELGLIGENCE, ERRORS OR OFF-SIGHTNESS.

7. I have read above release of Liabilities and Assumption of risk agreement, fully understand its terms. I understand that I have given my consent and given up my substantial rights by signing this agreement, and I am signing it freely, voluntarily, and without any inducement.

I accept as a Student or a legal guardian of a minor Student .

I have read the Program Details, Fee Structure and Policies of Karate Warriors Canada.

https://www.karatewarriors.ca/programs

https://www.karatewarriors.ca/policy

Please also save 2 number in your contacts:

Head Coach: Sensei Sam +1 647-620-8000
KW Team: +1 647-839-1158

Type your FULL NAME to acknowledge above.

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