Registration · Liability Waiver

Waiver & sign-up.

Please review and complete this waiver before your first class. A parent or guardian must sign for any participant under 18.

Participant information

Full legal name *

Date of birth *Email *

Phone *Address

Contact name *Contact phone *Relationship *

List any medical conditions, injuries, or medications that may affect training (write "None" if not applicable).

I understand that karate is a physical, full-contact martial art and that training carries an inherent risk of injury, including but not limited to bruises, sprains, fractures, or more serious injury.
I confirm that I (or the minor named above) am physically fit to participate and have disclosed any relevant medical condition.
I voluntarily accept these risks and release Kyokushin Kan Dieppe, its instructors, assistants, and the host facility from any claim of injury or loss arising from participation, except in cases of gross negligence.
I agree to follow the dojo etiquette, the instructions of the sensei, and the Dojo Kun at all times.

I have read and agree to the terms above.I consent to occasional photos/videos taken during class being used for dojo communications.

Signature (type full name) *Date *