Grand River Aikido Registation Form
Registration and Waiver of Liability
Registrant's Full Name *
Enter Full Name
Which Class Is Registrant Joining?
Select Class
Clear selection
Age Of Registrant *
Enter Age
Email Address *
Enter Valid Email
Email belongs to *
Phone Number *
Enter Your Phone Number
I assert that I/Registrant is in good health and able to participate in moderate to high physical exercise. *
If NO you are not eligible to enter into an agreement with Grand River Aikido
I am 18 years or older *
Define Your Status *
Define Your Relationship To Registrant
If Parent\Guardian enter your full name
I/We release Grand River Aikido, Ontario 2456375 and Lee Darke and it and his employees, agents and volunteers, its representatives elected or employed and its members, officers, directors, employees, agents, associations and volunteers,(“Releasees”) from all liability, recourse, proceedings, claims, and causes of action of any kind whatsoever, in respect of all damages, personal injuries, death or property losses (“Loss” or “Losses”) which I/we may suffer arising out of preparation for or participation in the Grand River Aikido (“Participation”), notwithstanding that any Loss was caused solely or partly by negligence of any Releasee. *
Agree To Release Of Liabilty. If NO you are not eligable to enter into an agreement with Grand River Aikido
Additonal Information
Please enter any additional information or medical conditions the Dojo should be aware. Keep in mind privacy. If you need to disclose personal information that is highly sensitive, then speak to Sensei Lee directly.
Can we add you to our email list?
The email list will be used for all important Dojo updates and to communicate information about cancelled classes etc.
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