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4 Week Trial Registration

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• I acknowledge that Martial Arts training is a contact sport which requires both dynamic and physically demanding exercises and that participation in Martial Arts carries a reasonable risk of injury.
• I certify that I am (or the student hereby represented is) in excellent physical health.
• I understand that the payment for my tuition is to be made as detailed and is not altered or affected by my attendance.
• I understand that failure to complete the lessons does not relieve me of my obligation to pay the agreed tuition terms.
• I acknowledge that whilst on School’s premises or any other place where I attend training and during all training times, both my property and my person shall be my own risk and I will not hold the school or its members liable for any property loss and damage or personal injury.
• I understand that additional fees will apply for any late fee instalments or any instalments not able to be collected on the specified date. Also I will be liable for any legal costs associated with recovering late or unpaid fees.
• I understand that the School reserves the right to terminate my membership at any time, following which I will only be liable for any outstanding training fees up to the date of membership termination.
• I authorize the instructor, first aid or medical officer to consent where it is impractical to communicate with me to receiving such first aid or medical treatment as may be deemed necessary.
• I understand that an official form must be completed and a minimum of 14 days notice is required to cancel my direct debit periodical payments. Failing sufficient notice, cancellation will take place on the subsequent withdrawal date.
• I acknowledge and agree that the Annual membership fee will be charged on the 1st of July each year and that for direct debit customers the fee will be automatically deducted from my nominated account.
• I give permission for photos and video footage of myself (or the student hereby represented) training and/or competing to be used for promotional and advertising purposes.
• I undertake to abide by the School’s rules and regulations and follow the traditions of the martial arts.
• I understand that the Karate School may be closed during the Christmas period (no longer than 2 weeks), this time is included in the training calendar and fortnightly fees will still apply.
I give permission for details of my medical condition and/or medical requirements to be displayed at the back of my attendance card for immediate access by the instructor should the need arise.
Please read carefully. This document affects your legal rights.


I do hereby submit my application for participation in the instruction of Martial Arts taught at Kiryoku Karate. I hereby assume full responsibility and liability for all damages, injuries and losses that I may incur while participating in or watching any and all training sessions.

I realize that serious injury in martial arts such as this one is likely and that even death is a possibility. I also realize that if I am injured, I might be disfigured, disabled and or rendered unable to work again. I realize that regardless of how these consequences may occur – whether it be the result of an opponent’s actions, the action or inaction of a training partner or instructor , the condition of the mats used, the conduct of a non-participant or any other reason – By entering into this agreement I accept the risk of training and being present at Kiryoku Karate and give up and waive all claims I or anyone acting on my behalf or through me might have against Kiryoku Karate, Kiryoku Karate partners, Chief Instructor, any and all of the instructors at the Kiryoku Karate school, training partners, operators, sponsors, officials, participants, non-participants or any employees and representatives for any injury regardless of its nature, effect or affect on me as a result of my participation and or presence at Kiryoku Karate.

I authorize whatever medical personnel that may be present at the Kiryoku Karate School to take any action necessary, should I become injured.

I represent that I am in good health; that I am not presently, nor will I participate while under the influence of any drug medication; that no one affiliated with this School has adversely encouraged me to train or made any representations regarding my fitness or ability to participate; that I have read and understood every provision of this release; and that I am legally competent to and freely enter into this waiver, release and assumption of risk agreement.
I hereby certify that I am parent or legal guardian of the above named minor; that I have read and understood every provision of this release; and that I am legally competent to and freely enter into this waiver, release and assumption of risk agreement on behalf of the minor and myself