WE ARE HAN

Student Name *

First Name

Last Name

Primary Phone *

(###)

###

####

Acknowledgment of Risks *

I understand that participation in martial arts training, including but not limited to Youn Wha Ryu Tae Kwon Do, sparring, weapons training (e.g., nunchucks, bo staff), board breaking, belt testing, and outdoor training sessions (collectively, “Activities”) at Grand Master Han’s Martial Arts of Morrilton (“Academy”) involves inherent risks. These risks include, but are not limited to: • Physical injury, such as bruises, sprains, strains, fractures, concussions, or other bodily harm; • Serious injury, including permanent disability, paralysis, or death; • Property damage or loss; • Emotional distress or psychological injury; • Risks associated with physical exertion, contact with other participants, or use of equipment; • Risks specific to outdoor training, such as uneven terrain, weather conditions, or environmental hazards; • Risks for participants with special needs, including challenges with coordination, communication, or physical limitations. I acknowledge that these risks may arise from my own actions, the actions of other participants, the condition of the facilities or equipment, or the negligence of the Academy, its owners, instructors, employees, agents, or other participants (collectively, “Released Parties”). I understand that the Academy serves participants ages 5 and up, including individuals with special needs, and that instructors may not specialize in adaptive training, which may increase certain risks.

Yes

Release and Waiver of Liability *

In consideration for being permitted to participate in the Activities, I, for myself, my heirs, executors, administrators, and assigns, hereby release, waive, discharge, and covenant not to sue the Released Parties from any and all liability, claims, demands, actions, or causes of action arising out of or related to any loss, damage, injury, or death that may be sustained by me (or the minor participant) while participating in the Activities, whether caused by the negligence of the Released Parties or otherwise.

Yes

Indemnification *

I agree to indemnify, defend, and hold harmless the Released Parties from any claims, damages, costs, or expenses, including reasonable attorney’s fees, arising from my (or the minor’s) participation in the Activities or breach of this agreement, including claims brought by third parties.

Yes

Medical Authorization and Responsibility *

I certify that I (or the minor participant) am in good health and have no conditions that prevent safe participation in the Activities, except as disclosed above. In the event of a medical emergency, I authorize the Academy to secure medical treatment for me (or the minor) and to share relevant health information with medical personnel. I agree to bear all costs associated with such treatment and acknowledge that the Academy does not provide medical insurance for participants.

Yes

Media Release *

I have read this agreement, fully understand its terms, and acknowledge that I am giving up substantial legal rights, including the right to sue the Released Parties. I sign this agreement freely and voluntarily, without inducement or coercion. If signing for a minor, I certify that I am the legal parent or guardian with authority to act on their behalf.

Yes

No

Rules and Conduct *

I agree to follow all Academy rules, instructions, and safety guidelines provided by instructors. I understand that failure to comply may result in removal from the Activities without refund. The Academy reserves the right to refuse service to any participant for any reason, subject to applicable law.

Yes

Governing Law and Severability *

This agreement shall be governed by and construed in accordance with the laws of the State of Arkansas. If any provision is found to be unenforceable, the remaining provisions shall remain in full force and effect. Any disputes arising under this agreement shall be resolved in the state or federal courts located in Conway County, Arkansas.

Yes

Acknowledgment of Understanding *

I have read this agreement, fully understand its terms, and acknowledge that I am giving up substantial legal rights, including the right to sue the Released Parties. I sign this agreement freely and voluntarily, without inducement or coercion. If signing for a minor, I certify that I am the legal parent or guardian with authority to act on their behalf.

Yes

Parent (If under 18) or Student Name *

This is a digital signature.

First Name

Last Name

Date *

MM

DD

YYYY