Agoge Organic Training Circle Event Registration
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Full Name *
Street Address *
City/State/Zip *
Phone number *
E-mail *
Emergency Contact (Full Name) *
Emergency Contact (Phone Number) *
Aikido Rank
Full Seminar Donation: $100

As part of registration, please send payment via Venmo or Paypal:

Venmo (write "donation" in purpose): @Alex-Peterson-89
Paypal (use friend/family option): @alexgpeterson

Contact if you have any questions.

I have been informed of the physical nature of the training in the martial arts of Aikido and its related teachings by the Agoge and associated dojos and members.. I understand that these trainings and teachings involves bodily contact and strenuous exercise. I understand that because of this there is an inherent risk of injury or death that cannot be eliminated. I understand that by undertaking these training and teachings that I am assuming the risk of possible injury to myself (or my child or ward). I understand these risks involved and hereby indemnify, hold harmless, release and forever discharge Agoge and associated dojos and their instructors, guest instructor and students, and the owner(s) of the property, from any and all claims which I or my estate may have which are directly or indirectly based on any injuries or health problems that result from or occur during or develop subsequent to my (or my child’s or ward’s) participation in trainings, teachings, classes, demonstrations or other activities conducted under the auspices of Agoge and associated dojos and their instructors. 

I, also permit and grant to Agoge and associated dojos and their instructors right to reproduce, distribute, and sell photographs or videos of me or taken by me during events of Agoge and associated dojos.

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