I acknowledge that I am applying for instruction in a martial art involving strenuous exercise and personal body contact and that might result in bodily injury including permanent disability or death and severe social and economic losses and damages due not only to my own negligence, but also the negligence of others. I further acknowledge that other risks, not known or foreseeable at this time, could arise.
I agree that before using the mat or equipment, I will inspect the facilities and equipment that I use, and if I believe anything is unsafe, including the exercise or technique, I will immediately advise the instructor present and will decline to participate in training any further.
I have read, understood, and will comply with each part of the CDC’s “universal precautions” as modified for Aikido training in order to reduce the already slight risk of transmission of HIV and other blood and body fluid-borne diseases.
I also understand that I may be exposed to individuals in the dojo that may have an infectious disease that may be spread by air borne transmission, respiratory droplets or person to person contact, including but are not limited to the common cold, norovirus, flu virus and other respiratory diseases such as Covid 19 (SARS-CoV-2). I have read and will follow the dojo’s policy on protocols for avoiding the transmission of infectious diseases including not working out if I have a fever greater than 100.4 degrees or other symptoms including chills, sweats, difficulty breathing, new or worsening cough, whole body aches, vomiting or diarrhea (see attached Hygiene Protocol form).
As a condition to participating in martial arts training at Inaka Dojo, I assume the risk of all injuries including the transmission of infectious diseases and hereby hold Inaka Dojo, their instructors, agents, officers, as well as the owner of the premises, and the Aikido Schools of Ueshiba, Inc. (ASU) harmless from any and all liability (including attorney’s fees and costs) for (1) all claims, actions or damages due to injuries including infectious diseases suffered by me or caused by third parties to me arising out of activities involving Aikido, any other martial arts or physical activities occurring on the premises of Inaka Dojo, Inc., 700 Dixie Highway, Beecher IL 60401; and/or (2) loss or damage to personal property brought into or left on the premises.
I acknowledge that this event may be recorded by video or other means. I agree to being recorded in the format used and that Inaka Dojo may use my image in any format for all legal purposes both commercially and non-commercially.