Visitor Registration

By clicking this box I certify that I voluntarily submit this application for membership in the East Montgomery Martial Arts Academy, LLC. I hereby represent that (I/my child) is physically fit to take the course of instruction and that (I have/he/she/has) had an opportunity to observe, participate, and understand the activities required prior to the signing of this agreement. I certify that (I have/my child has) no medical or other condition which would prevent, impair or become exacerbated by lessons or practice of the prescribed course or instruction. I understand that in the course of instruction, ACADEMY employees and/or other students or authorized persons will be engaged in conduct requiring physical contact with me/my child; I give full consent to such contact as is required by the training and/or deemed necessary or appropriate by the ACADEMY. I understand and agree that I will hold harmless and indemnify the ACADEMY for any and all damages sustained by me or my child or any member of my family whether or not occasioned by the negligent acts and/or omissions of the ACADEMY, its agents, servants, and/or employees or any third party where such damage is a result of any act or omission occurring on the premises of the ACADEMY or at any facility wherein the ACADEMY conducts its business, including, but not limited to, tournament sites, camps, etc. I understand that this means I am releasing and indemnifying the ACADEMY from all claims for damages to me, my child or other members of my family for any and all negligent acts or omissions on the part of the ACADEMY, its agents, servants and/or employees and/or third parties. I further understand that enrollment is subject to approval by the Head Instructor of the East Montgomery Martial Arts Academy, LLC. It is further understood and agreed that Kokoro Kai, LLC does not warrant the activities or conduct of the ACADEMY or its personnel and will not be liable to (me/my child) for any injuries, damages, etc. caused by or resulting from such acts or omissions.