IMMORTAL PALM MARTIAL ARTS

Welcome!! We are glad you are here and we hope that this visit will be enjoyable. Please feel free to ask any questions that you may have.  Please complete the following Registration form. Please also read the attached Waiver of Liability form and then sign and date it in the spaces provided.

                                                                            REGISTRATION   

Name:  {name}

Address: {address}

Phone: {phone}

Date of Birth: {dob}

WAIVER OF LIABILITY

I/we, the undersigned, do hereby acknowledge that I/we understand that training/ participation in the martial arts and or, specifically Wing Chun Kung Fu, Chen Tai Chi, Tong Bei, Bagua, Tai Chi Weapons, Sparring involves risk and hazards in said training /participation. Notwithstanding the above, I/we, are desirous of training /participating in Immortal Palm Martial Arts.  Accordingly, I/we, by these presents do, for myself/ourselves, my/our heirs, successors, representatives and assigns do hereby waive, release and forever discharge Immortal Palm Cleveland LLC, John Turnbull, Carl Dechiara, and any of its/ their representatives, agents, servants and employees from any and all liability, claims, causes, of action, joiners for sole liability, contribution, indemnity or otherwise, damages, cost, expenses or demands of any kind whatsoever in law or equity which I now have against the it/them, which I/we ever had, or which I may have in future or which my heirs, successors, representatives and assigns hereinafter can, or may have, by reason of bodily or personal injury, property damage, contract or the consequences thereof, known or unknown, foreseen or unforeseen, arising out of , or any way connected with my/our training/ participation in Immortal Palm Martial Arts.

I/we, the undersigned, do hereby grant to Immortal Palm Martial Arts the right to use my name and image for the purpose of promoting the school.

I/we, the undersigned, do hereby acknowledge that this is a complete waiver/ release agreement and that there is/are no written or oral understanding or agreement directly or indirectly connected with this waiver/release that is not incorporated herein.

With the intent to be legally bound. I/we have executed this waiver/ release below on the date indicated.

Date: {sign_date}

Student (or guardian if under 18): {sign_name}