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Release form
I, the undersigned, certify and acknowledge: That the instuctor has advised me, prior to my or my children's commencement of participation in Kung Fu, L'l Dragons, aerobics and any other classes, that such participation involves vigorous exercise which could result in physical injury and that I freely and knowingly assume the risks inherent in participation in any of the above programs and I hereby waive any right, claim, or cause of action against Hip Kyun Kung Fu school, the instructor and all other instructors or persons who may help during class, and release them from any result of my participation in any of the above programs. I also allow that photos, videos, etc may be used at any time without compensation to me.
I understand that a $20.00 membership fee is to be paid on the day I register(if making a check, make it payable to Hip Kyun). I accept to make my weekly or monthly payment as notified; otherwise I will be resonsible for court and lawyer's expenses like the law permits you to do so. A total of $20.00 will be charged for a NSF check. No credit will be allowed. This contract is not transferable.
I declare having read this contract and agree with the conditions mentioned.
Full Name: Date:
Date of Birth: Telephone:
Medicare Number:
Are you new to Hip Kyun? Yes No
If no what rank do you hold? Adress:

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*Upon beginning classes students will be required to fill out a release form wereas this form is only a means of letting us know of those who are interested. All those who fill out a form on our webpage will be contacted by phone or e-mail to confirm their interest in our school. If student is under the age of 18 a parent or guardian's signature will be required.

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