Sword Circle Waiver: 1/01/24 - 12/31/24
This waiver is an agreement of consensual participation, by the participant (named below), in any of the classes, lessons, demonstrations, and/ or services provided by Sword Circle. This waiver is signed voluntary by the participant. By signing this wavier, the participant agrees to the contents within this waiver, in addition to release Sword Circle, its members, staff, owners, of any/ all possible injuries, physically, mentally, emotionally, and/ or spiritually, that may/ occur in a martial arts setting provided in classes, lessons, demonstrations, and/ or services by Sword Circle. The participant hereby agrees: a) the participant accepts participation, including the rules mandated by Sword Circle b) the participant agrees to release Sword Circle of any legal responsibilities toward any/ all injuries that may occur participating in any/ all classes, lessons, demonstrations, services, hosted by Sword Circle. c) the participant accepts risk in participation of martial arts activities and does not enact, nor to seek, any legal compensation against Sword Circle.
Sign in to Google to save your progress. Learn more
Email *
Date of signing Safety Form *
MM
/
DD
/
YYYY
Participant Date of Birth *
MM
/
DD
/
YYYY
Participant First Name *
Participant Last Name *
Participants nickname (not required)
Full Name of Legal Guardian
Only required if participant is a minor. N/A if not a minor.
Email *
If the participant is a minor, please provide the email of the participant's legal guardian. 
Email (minor or additional email)
Participant Phone Number *
If the participant is a minor, this should be the phone number of the participant's legal guardian.
Phone Number (minor or additional number)
Emergency Contact Full Name *
Emergency Contact Phone Number *
Which category class are you seeking to take? *
Which class are you most interested in taking? *
Required
Medical Conditions:
Please list any diagnosed medical conditions and/ or limitations that could result in difficulties when participating in any/ all requirements while participating in classes (i.e. physical shoulder surgery, emotional military deployment PTSD, mental autistic spectrum, etc.) -N/A if none occur.

**we do not seek nor request medical records or details, as we are not to hold this information on file. This is for the awareness to inform instructions to better assist teaching student(s) the curriculum 
 *
STUDENT HANDBOOK:

During/ after your first class, before participating as a full-time member, you will receive a copy of our STUDENT HANDBOOK. All members will be sent this form for all members to read, sign, and submit back to Sword Circle before they are eligible to participate as a full-time member 
in any classes. Upon Sword Circle receiving this waiver, Sword Circle will email this form 2-5 days to the email address above prior to being eligible to participate. 
 *
Required
MEDIA RELEASE:

I, the undersigned, give permission to Sword Circle & affiliated Clients of Sword Circle (hereafter referred to as "the Company(ies)") to use, reproduce, distribute, display, and create derivative works of the above-described media in which I appear.

I acknowledge and agree that the Company may use the media in various formats and through different channels, including but not limited to websites, social media platforms, advertisements, broadcasts, publications, and any other promotional or educational materials in any medium.

I understand that I will receive no payment or other compensation for the use of the media.

I release and discharge the Company(ies) and its agents, Clients, 3rd party representatives, members, and assignees from any claims, actions, damages, costs, or liabilities of any kind, whether in connection with the use of the media or otherwise.

 *
Required
I, AS THE PARTICIPANT, AGREE AND AGREE TO THE FOLLOWING;

I am voluntarily participating in the martial arts sword fight exercise/fitness classes, lessons, demonstrations and services conducted by Sword Circle. I recognize that the classes, lessons, demonstrations and services may require physical exertion that may be strenuous at times and may cause physical injury. I am fully aware of the risks and hazards involved. I understand that it is my responsibility, if need be, to consult with a physician prior to and regarding my participation in the above mentioned program. I represent and communicate through this form that I have no medical condition that would prevent my participation in the program. I agree to assume full responsibility for any risks, injuries, or damage known or unknown which I might incur as a result of participating in the program. Such injuries may include, but are not limited to: heart attacks, muscle strains or sprains, muscle pulls, muscle tears, broken bones, shin splints, heat prostration, injuries to knees, injuries to back, injuries to feet or hands, or any other illness or soreness, including death. I knowingly, voluntarily and expressly waive any claim I may have against the Sword Circle organization, as well as it's instructors and students, for injury or damages that I may sustain as a result of participating in the program. I, my heirs, or representatives forever release waiver, discharge and covenant not to sue Sword Circle and it's instructors, for any injury or death caused by their negligence or other acts. I voluntarily agree to the terms and conditions stated above and agree to the above waiver and release of liability.‎ Sword Circle reserves the rights to dismiss any participant that might infringe these terms and conditions, without warning or refunds, rather by accident or intentional negligence, in order to preserve the safety for the greater community whom could be directly, or indirectly, affected. My digital signature acknowledges I have fully understood this Waiver and agree to its terms.

 I AM A WILLING PARTICIPANT AND ACKNOWLEDGE ANY/ ALL RISK THAT MAY APPLY IN A PHYSICAL SPORT/ ACTIVITY.
*
Required
Digital Signature *
By typing your name here you agree to all the terms and conditions as stated above, that you have read our forms and fully understand them, and that the information provided above is true and correct. You acknowledge that your name typed here is serving as a signature on these forms.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms