Kung Fu & Tai Chi | Martial Arts Winnipeg

Kids Kung Fu AdultKungFu TaiChi

First Name

Last Name

Male Female

Birthdate

Phone

Martial Arts Background/Years of Traing

TERMS & CONDITIONS

I, the undersigned, do hereby for myself, my executor(s), and my heirs, agree to hold harmless, PLUM BLOSSOM MARTIAL ARTS ACADEMY INC.,
of Winnipeg, Manitoba, and all of its officers, officials, volunteers, and members, and all others for liability, losses,
or injuries which I may sustain by way of my direct or indirect involvement in any and all training sessions and/or events associated
with PLUM BLOSSOM MARTIAL ARTS ACADEMY. This will include any losses, liabilities, injuries sustained as a result of traveling to and from,
and participating in these events. I am fully aware that liabilities, losses and injuries may result from my participation in said events
and I enter these events entirely at my own risk. Additionally, I am fully aware of my personal medical condition and hereby certify that
I am mentally and physically fit to participate in said training and events. I grant permission to PLUM BLOSSOM MARTIAL ARTS ACADEMY,
its representatives and employees to use any photographs submitted by myself of the like or of my property in connection with the above-identified subject.
I authorize PLUM BLOSSOM MARTIAL ARTS ACADEMY, its assignees and transferees to copyright, use and publish the same in print and/or electronically.
I hereby affirm that I am over the age of majority and have the right to contract in my own name. I have read the above authorization,
release and agreement, prior to its execution; I fully understand the contents thereof.This agreement shall be binding upon me and my heirs,
legal representatives and assignees.

I AGREE TO THE TERMS & CONDITIONS: