Application for summer camp

WAIVER, RELEASE AND INDEMNITY AGREEMENT

IMPORTANT: THIS RELEASE IS A LEGAL CONTRACT BINDING UPON YOU, UNITED STUDIOS OF SELF DEFENSE HALF MOON BAY or USSD HMB, ITS EMPLOYEES AND ASSOCIATES. READ IT CAREFULLY AND OBTAIN LEGAL ASSISTANCE IF YOU DO NOT UNDERSTAND IT.

I, the undersigned, acknowledge and state that I have voluntarily applied to become a member of and to participate in the activities of United Studios of Self Defense (USSD), including but not limited to, the instruction, techniques and methods commonly known as Karate, Brazilian JiuJitsu and Sparring. I am aware and understand that Jiu-Jitsu and Sparring are potentially dangerous activities. I am voluntarily of my own free will submitting an application for membership, becoming a member, and learning and participating in the United Studios of Self Defense Half Moon Bay training methods with full knowledge and understanding of the potential danger and hazards involved. I hereby consent and agree to completely accept alone any and all risks of injury or death. I also acknowledge and understand that the performance, practice, training and utilization of Karate, Brazilian Jiu-Jitsu and Sparring involve extremely strenuous physical activity, and that I have been advised to consult a physician before commencing and undertaking such activity. I hereby represent that, to the best of my knowledge, I am in good USSD 80 Cabrillo Highway N, Suite C Half Moon Bay, Ca 94019 650-712-8891 www.ussdhmb.com hmbussd@gmail.com PLEASE CIRCLE: WEEK 1: June 19-23 WEEK 3: July 31-Aug 4 WEEK 2: June 26-30 WEEK 4: Aug 7-11 Camp is for Ages 5-13 Time: 8am-1pm Fee: $400 for 1 week or $1,500 for all 4 weeks ($375 per week) Summer Camp-Self Defense-Shaolin Kempo-Martial Arts-Gymnastics-Discipline physical health and condition, sufficient to undertake the activities and practices of Karate, Brazilian Jiu-Jitsu and Sparring. I hereby declare that I have read this release from liability, and that I fully understand the meaning and importance of its contents. I acknowledge that this release is a binding contract among United Studios of Self Defense Half Moon Bay and its associates: and that under this contract I am releasing United Studios of Self Defense Half Moon Bay and its associates from all liability for any claim I have against them. I further declare that I have full legal capacity to be bound to this contract, and that I am signing this contract of my own free will.

Summer Camp Application