Doran 60th Seminar Waiver

WAIVER, RELEASE OF LIABILITY, ASSUMPTION OF RISK AGREEMENT, AND PARTICIPATION AGREEMENT

In consideration of being allowed to participate in any way, including travel to and from the martial arts practices, seminars, clinics, classes, events, and activities of Aikido West I hereby

1.     Understand and agree that prior to participating, I have the right and duty to inspect the mats, equipment and facilities to be used, and if I believe that anything is unsafe or beyond my ability I will immediately advise the instructor or supervisor of such condition(s) and refuse to participate.

2.     Acknowledge and fully understand that I will be voluntarily engaging in activities that involve contact and that might result in serious injury, including permanent disability or death, and severe social or economic losses due to not only my own actions, inactions or negligence, but also to the actions, inactions, or negligence of others, or conditions of the premises or of any equipment used. Further, I acknowledge that there may be other risks not known to me or not reasonably foreseeable at this time.

3.      Assume all of the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability, or death.

4.     Release, waive, discharge, and covenant and agree not to sue or make claim against Aikido West or any of its affiliated organizations, their respective agents, officers, directors, instructors including but not necessarily limited to visiting, guest and substitutes, employees, volunteers, sponsors, members, other participants, their parents, guardian(s), supervisors, and if applicable, owners, lessors, and lessees of any premises used by Aikido West. or any of its affiliated organizations, all of whom are hereinafter collectively referred to as “Releasee”, from any and all claims, demands, losses, or damages on account of injury, including permanent disability and death or damage to property, caused or alleged to have been caused in whole or in part by the negligence of the Releasee or otherwise.

5. Agree to follow the Blood & Body Fluid Policy.

Aikido West BLOOD & BODY FLUID POLICY

To protect Aikido West members from risk of disease, Aikido West has adopted the following policy to minimize the risk of transmission of HIV, Hepatitis B, and other blood and body fluid borne pathogens during Aikido training. Although current available evidence suggests that risk of transmission of HIV or other pathogens during the type of body contact that occurs in Aikido training is slight, all members should observe these “universal precautions” as modified for Aikido.

BEFORE TRAINING

• Be sure all fingers and toenails are trimmed.

• Cover all open cuts or sores with a suitable antiseptic and cover them securely with a leak proof dressing before coming on the training mat.

• Cover all healed wounds that might open during practice with a leak proof dressing.

• No jewelry of any kind should be worn on the mat. If you must wear jewelry, you must cover it with tape.

PROCEDURE FOR WOUNDS INCURRED DURING TRAINING

• If you or your partner should begin to bleed, stop practice immediately.

• The person who is bleeding should quickly leave the mat and cover the wound.

• After covering the wound, the injured person should clean the blood from the mat. To clean the mat, cover the blood with hydrogen peroxide, let it sit for 30 seconds to lift the stain, then dry it with a disposable towel. Then use disinfectant over the area, and once again dry it with a disposable towel.

• The partner of the person bleeding should stand near the area of spilled blood and keep other practitioners from coming into contact with the spilled blood. He or she should also protect the person who is cleaning up the blood.

• If you come into contact with blood that is not your own, you should quickly wash off the area with soap and water.

• If an injured person needs assistance, each person assisting should wear a pair of latex gloves.

• All used gloves, bloody cloths or towels, and dressings should be placed in a leak proof plastic bag and disposed of carefully.

I HAVE CAREFULLY READ THE ABOVE WAIVER AND RELEASE OF LIABILITY AND FULLY UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT AND KNOWING THIS, I DO SIGN IT VOLUNTARILY. I AGREE TO PARTICIPATE KNOWING THE RISKS AND CONDITIONS INVOLVED AND DO SO ENTIRELY OF MY OWN FREE WILL.

Who will be participating?

Adult  Adult and Children  Children

Parent / Guardian Information

* Optional:

Create a password to save time and auto-fill your information on your next visit!

Attachments

Please attach an image of your vaccine card or vaccination appointments

By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.