Welcome to Echo Martial Arts! Come Try a Class!

Student Information

Student First Name *

Student Last Name *

Attending with a Group *

YES

NO

Birthdate (mm/dd/yy) *

Age at Registration *

Prior Karate Experience? *

Yes **

No

** If student has prior karate experience, please CONTACT US (link) to discuss which class to attend.

New students without experience should attend a WHITE BELT

class offered Mon or Wed 5:15-6:00pm

Parent Contact Information

Parent/Guardian First Name *

Parent/Guardian Last Name *

Address *

Address 2

City *

State/Province *

Zip/Postal Code *

Phone *

Email Address *

Preferred way to contact *

Phone Call

Text

Email

Any

Terms and Conditions *

The Echo Martial Arts Student Waiver is required for all students even those trying their first class.

Each segment must be agreed to in order to participate. Parent or Guardian must complete the following for any minor child representing the child.

I represent and warrant that I am physically fit and I have no preexisting conditions that will prevent my full participation in the training provided by Echo Martial Arts LLC. *

Yes

I understand it is my personal responsibility to consult with a physician during my participation with my physical training or program participation with Echo Martial Arts LLC *

Yes

I acknowledge and fully understand nature and the risks associated with strenuous exercise and engaging in a contact sport and martial arts training, including the risk of bodily injury, fractures, ligament tears, arthritis, concussion and head injuries, heart attack, permanent disability, stroke or even death, but knowing these risks, it is my desire to participate as herein indicated. *

Yes

I expressly, willing, and voluntarily assume full responsibility for all risks of any and every kind involved with or arising from my participation in the Martial Arts training and associated activities with Echo Martial Arts, LLC., whether during in class instruction, use and or purchase of any and all types of equipment provided by Echo Martial Arts, LLC, video review, sparring, self defense training, competition preparation and competitive events, weapon training, gymnastic tumbling and tricking and instruction, cardiovascular exercise, mixed martial arts, grappling, travel to or from or otherwise supervised and /or unsupervised activity. Without limiting the generality of the foregoing, I hereby irrevocably release Echo Martial Arts LLC, Gerald Johnson, Gabriel Johnson, its employees, agents, representatives, contractors, subcontractors, successors, heirs, assigns, affiliates, and legal representatives (hereinafter referred to as “Released Parties”) from, and hold them harmless for, all claims, rights, demands or causes of action whether known or unknown, suspected or unsuspected, arising out of the training and instruction of said martial art activities. *

Yes

I hereby, Release, Waive, Discharge and Covenant Not to Sue Echo Martial Arts LLC, Gerald Johnson, Gabriel Johnson, its employees, agents, representatives, contractors, subcontractors, successors, heirs, assigns, affiliates, and legal representatives (the “Released Parties”) from, any and all litigation expenses, attorney fees, Loss Liability, Damage or Costs on account of Injury, Illness, Disease, Including Permanent Disability and death or damage to property, caused or alleged to be caused whole or in part by the negligent acts or Omission of the ‘Released Parties” or otherwise to the fullest extent permitted by law. *

Yes

I have read and understand the above warning, waiver and release. I understand that I have given up substantial Rights by signing this document, and I knowingly sign this voluntarily and without any inducement or assurance of any nature. I agree to participate knowing the risks and conditions involved and do so entirely of my own free will. I affirm I am over 18 years of age and /or I have legal guardianship as evidenced by signature below. I intend this to be a complete and unconditional release of all liability to the greatest extent allowed by Utah State Law and agree that if any portion of this agreement is held to be invalid that the balance, notwithstanding, shall continue in full force and effect. *

Yes

** Parent or Legal Guardian of Minor Age **

This is to certify that I, as Parent or Legal Guardian with legal responsibility for this participant, do consent and agree to release and agree to indemnify and hold harmless the “Released Parties” from any and all liabilities incident to my minor child’s involvement or participation including litigation expenses, attorney fees, loss, liability, damage or costs which may incur as the result of the minor child’s participation in these programs as provided above, even if arising from their negligence, to the fullest extent permitted by law. I have instructed the minor participants as to the above warning and conditions and their ramifications. *

Yes

I accept that clicking SUBMIT serves as my signature and agreement to the answers above. *

Yes