Registration - Adult Students
This form is for students who are over the age of 18 and do not require the signature of a parent or legal guardian.
Email address *
1. In consideration of being accepted as a student of SHODOKAN, Inc. (A non-profit organization), I *
agree to adhere to the rules and regulations of SHODOKAN, Inc. and all applicable rules and regulations of the associations and federations governing the arts and disciplines taught at SHODOKAN, Inc. I further agree to pay dues in the amount of dues in the amount specified below per month, payable during the first week of each month, whether I have attended training sessions or not, unless I have requested, in writing and submitted prior to any period of absence, a Leave of Absence or Resignation. I also understand that I am free to resign any time for any reason, but that unexcused absence for two (2) months terminates my student status. Re-instatement requires re-registering and back payment for any period of unpaid practice.

2. I FURTHER UNDERSTAND that although every effort is made to assure safety, martial arts practice has inherent risks of injury. Therefore, I assume any and all risk of injury while practicing any and all arts taught at SHODOKAN, Inc. while participating in any and all activities held at SHODOKAN, Inc. or while on the premises of the SHODOKAN, Inc. I agree to hold SHODOKAN, Inc. its officers, directors, students, seminar participants, spectators, and guests harmless and free from any and all liability for any and all injuries sustained.

3. SHODOKAN, Inc. is not responsible for lost, stolen or damaged property.
Payment *
First Name *
Last Name *
Date of Birth *
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Occupation / School
Phone *
Address *
City *
State *
Zip *
Date of Application *
Martial Arts Experience
Rank Achieved
Reason for Joining
Class *
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