DKA-Fall-Clinic-Sept2019
DKA-Fall-Clinic-Sept2019
Dynamic Karate Annual Fall Clinic
Event Times:
- Friday September 27. 6:15pm - 9:30pm (Belvedere Parkway School - 4631 85 St NW, Calgary, AB T3B 2R8)
- Saturday September 28. 9am - 4pm (Twelve Mile Coulee School - 65 Tuscany Hills Rd NW, Calgary, AB T3L 0C7)
- Sunday Septebmer 29. 6pm - 10pm (Glamorgan Karate Club - 3602 8 Street SW)

Contact Darren at 403.671.5662 or darren@dynamickarate.ca

This is a combination of clinics and an official Shintani Wado Kai Karate Kata Clinic. For the clinic all participants brown and up will receive a course completion certificate.

The Sunday workout will be a World Traditional Karate Association Black Belt Grading.
Name *
Your answer
Email Address *
Your answer
Rank *
Required
Clinics To Attend *
Required
Payment Method *
PARTICIPANT INFORMATION, WAIVER OF CLAIM, & ASSUMPTION OF RISK
*** Please read carefully before signing: all participants are required to have this form properly completed and on record with club instructors. ***

In consideration of the benefits received by me and of permission granted now or in the future to participate in Sintani Wado Kai Karate training, I agree and acknowledge that:
1) I have met all of the prerequisites and conditions required for participation in karate.
2) I will abide by the rules and decisions imposed on the participants of this Karate program.
3) I recognise there are risks and hazards inherit in the very nature of the Karate and that as a result of these risks and hazards, I, as a participant may suffer accident, personal injury including death, as well as loss or damage to personal property. I nevertheless freely and voluntarily assume the aforesaid risks and hazards and accordingly my participation in
the Karate shall be entirely at my own risk.
4) I agree now and in the future to indemnify, hold and save harmless from any claim (including medical expenses), liability, suit, action or other proceeding of any kind arising from my participation in Karate training. Glamorgan Wado Kai Karate and their officers, agents, employees, instructors, fellow participants or authorised guests.
5) The Karate officials may secure such medical advice and services as they, in their sole discretion, may deem necessary for my health and safety and I shall be financially responsible for such advice and services.
6) This INFORMATION, WAIVER OF CLAIM and ASSUMPTION OF RISK is binding on myself, my heirs, my executors, administrators, personal representatives and assigns.

Dynamic Karate Association promotes our activities & celebrate club and individual achievements. GKC is built upon its membership. We will use photos or videos to promote Dynamic Karate and the Shintani Wado Kai Karate Federation.

Completing this form confirms your consent in having your name, photos and videos in any promotions.

I hereby give permission to Dynamic Karate.

*** If the participant is under the age of eighteen (18) years, a parent or legal guardian must sign; no other signature will be accepted. ***
Consent Agreement *
Required
Signature
Your answer
Date *
MM
/
DD
/
YYYY
Submit
Never submit passwords through Google Forms.
This form was created inside of Dynamic Karate Association. Report Abuse - Terms of Service