Event Waiver

Participant Name

First

Last

Is the participant a minor? (under age of 18)

Yes

No

Date of Birth

Parent or Legal Guardian

First

Last

Section

Contact Phone Number (SMS capable)

SMS Consent

I consent to receive non-marketing SMS messages from Professional Martial Arts Institute, LLC DBA Professional Karate Institute Mixed Martial Arts (PKIMMA) regarding class reminders, schedule updates, and responses to my inquiries. Message frequency may vary. Message & data rates may apply. I am 18 or older. Text HELP for assistance or reply STOP to opt out.

I consent to receive marketing SMS messages from Professional Martial Arts Institute, LLC DBA Professional Karate Institute Mixed Martial Arts (PKIMMA) about special offers, events, programs, camps, tournaments, and promotions. Message frequency may vary. Message & data rates may apply. I am 18 or older. Text HELP for assistance or reply STOP to opt out.

View our Privacy Policy and Terms & Conditions

Contact Email

Physical Address

City

State/Province

Zip/Postal

Add Additional Minors

Turn on to register additional minors on this event waiver.

Additional Minors

Participant Name

First

Last

Date of Birth

Add Remove

Liability Waiver

I have read, understand and agree to the conditions outlined herein

In consideration of your acceptance of my enrollment, I do hereby, for myself, my heirs, executors, and administrators waive, release, and forever discharge any and all rights and claims for any damages which I may have or may accrue to me against Professional Karate Institute and its organizing committees, and all members in connection with this training and/or event. I understand that Ju Ki Do is a body-contact sport which involves a risk of injury including permanent disability, paralysis, and death; therefore, I fully accept and assume all such risks and responsibility for losses, costs, and damages incurred as a result of the participation in the said training and /or event.

Media Consent

I consent and agree that any pictures and/or videos taken of or by me in connection with said training and/or event may be used by the director for publicity or promotion at any time, either now or in the future.

Electronic Communications Consent

I am authorizing Professional Karate Institute Mixed Martial Arts and its organizing committees to send me future written correspondence regarding my account(s) via email and/or text messaging. My email and/or text messaging authorization does not obligate Professional Karate Institute Mixed Martial Arts to communicate with me by email and/or text messages to my cell phone or cease non-electronic communication. I am advised that some circumstances may prevent Professional Karate Institute Mixed Martial Arts from responding to my inquiry by email and/or text messaging.

Certification

By signing below, I certify that I am at least 18 years old. I have read and fully understand the above Liability Waiver and Consents for myself and/or my minor child.

Signature

Clear

General Event Waiver

Section

Additional Minors