Participant Name *

First Name

Last Name

Date of Birth (Participants must be at least 7 years old): *

MM

DD

YYYY

Gender

Male

Female

Primary Contact Name

(Parent or Guardian if participant is under 18 years of age)

First Name

Last Name

Primary Contact Phone *

(###)

###

####

Emergency Contact *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####

Release of Liability *

To the best of my knowledge, I am in good physical condition and fully able to participate in this course. I am fully aware of the risks and hazards connected with the participation in Martial Arts including physical injury or even death, and herby elect to voluntarily participate in said event, knowing that the associated physical activity may be hazardous to me and my property. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OR LOSS, PROPERTY DAMAGE, OR PERSONAL INJURY, INCLUDING DEATH, that may be sustained by me, or loss or damage to property owned by me, as a result of participation in this program. I further certify that I am at least 18 years of age. If under 18, my parent/guardian is the below signed.  I hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE, Inspire Martial Arts, Dana Johnson, their officers, servants, agents, and employees (hereinafter referred to as RELEASEES) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, while participating in physical activity, or while on or upon the premises where the event is being conducted. It is my expressed intent that this release and hold harmless agreement shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a RELEASE, WAIVE, DISCHARGE, and CONVENTION TO SUE the above named RELEASEES. I hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be constructed in accordance with the laws of the Province of Alberta. In signing this release, I acknowledge and represent that I HAVE READ THE FOREGOING Waiver of Liability and Hold Harmless Agreement, UNDERSTAND IT AND SIGN IT VOLUNTARILY as my own free act and deed; no oral representations, statements or inducements, apart from the foregoing written agreements have been made; and I EXECUTE THIS RELEASE FOR FULL, ADEQUATE AND COMPLETE CONSIDERATION FULLY INTENDING TO BE BOUND BY SAME.

I acknowledge and accept the release of liability above

Inspire Martial Arts Terms & Conditions *

1. Inspire Martial Arts, and it’s officers, reserves the right to dismiss a participant either on a temporary or permanent basis should the Instructor/s deem a student’s conduct is unbecoming of a martial arts practitioner. 2. Muay Thai is a long-term commitment. It is expected that students will keep their membership active. Inspire Martial Arts does not guarantee space for re-enrollment after any break from training except in the case of a temporary medical withdrawal, pre-approved by Inspire Martial Arts leadership. 3. Any student wishing to withdraw is responsible for cancelling upcoming monthly payments using the link on any prior invoice/receipt, which is sent by email to the primary account holder. Inspire Martial Arts will not be responsible for cancelling these payments. While we would appreciate advance notice, you may cancel at any time. However, training will cease immediately. There will be no refunds in whole or in part for any reason. 4. Membership fees are non-transferable. 5. Family rates are provided only to those family members who live at the same address. 6. Terms & Conditions are subject to change without notice.

I agree to the Terms & Conditions as outlined