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 Release Of Liability Form

For and into consideration of the permission of Pro Sessions Aikido to use its facilities and of the execution by others of agreement similar here to, the undersigned hereby agrees that while upon premises used by Pro Sessions Aikido or while using its equipment at any location for the purpose of practice or of demonstration, said premises, facilities, and equipment shall be occupied and used at the sole risk and responsibility of the undersigned, and the undersigned hereby releases Pro Sessions Aikido from any and all claims for personal injury, damage, or loss of any kind or description resulting from being thereon or from such use or from the acts of any person thereon. The undersigned further agrees to indemnify and hold harmless Pro Sessions Aikido and each of its instructors, teachers, officers, and members from or against any and all claims made or instituted against it or them arising out of the act of the undersigned while upon premises used by Pro Sessions Aikido or while using its equipment for the purpose of practice or demonstration, including injury or loss to the undersigned however caused an injury or loss caused by the undersigned to any other person.I certified by my signature that I have read and understand this agreement in its entirety and all of my questions regarding it have been fully answered. I understand that Pro Sessions Aikido documents activities and events involving classes and instruction. I give Pro Sessions Aikido permission to use any documentation, such as videotaping, photography, or fail, in which my image is taken in whatever way Pro Sessions Aikido wishes. I understand that Pro Sessions Aikido is the sole owner of this documentation.

Release of liability form

Student Information

Emergency Contact Info

Martial Arts History

PRO SESSIONS AIKIDO  800-625-7115