BCKF Waiver Form - Black Crane Kung Fu

I, the below mentioned person pledge never to use the training techniques I have been taught in aggression, but to use my training only for legitimate self defence. I will endeavour to uphold this pledge at all times. I agree to the following rules of the Schools and I am aware that the Schools may terminate my training at any time should my instructor, for any reason, find it necessary to do so.

Date(Required)

Signature(Required)

1. APPLICANT’S DETAILS:

Date of Birth(Required)

Phone/mobile number(Required)

Place of Birth(Required)

Occupaton(Required)

Name of Employer(Required)

Marital Status(Required)

E-mail Address(Required)

Email(Required)

PERSONAL DESCRIPTION

Height(Required)

Weight(Required)

Build(Required)

Hair Colour(Required)

Eye Colour(Required)

2. HEALTH DECLARATION

If yes, what drugs?(Required)

If yes, give details(Required)

Name and indentify any psychical impairments, injuries or medical conditions that currently affect you(Required)

If yes, please describe(Required)

3. MARTIAL ARTS HISTORY

Style(Required)

Grade achieved(Required)

Number of years studied(Required)

Name of your instructor(Required)

4. EXCLUSION OF APPLICANT

If yes, please give details(Required)

5. DECLARTION OF UNDERSTANDING

Martial Arts is dangerous

I have read and understood the terms of the Martial Arts Contract or if I did not understand the terms of the Contract I requested an independent person to explain them to me.

Date(Required)

Applicant Signature(Required)

Witness Signature(Required)

This field is hidden when viewing the form

Age – under 18

6. GUARDIAN’S CONSENT: (for all persons under 18 years)

I hereby certify and decree that all the information contained in the declarations above is true and accurate.

Signature(Required)

Relationship to Applicant(Required)

Guardian Phone number(Required)

Martial Arts Contract

MARTIAL ARTS IS DANGEROUS

The following conditions must be read carefully:

1. Interpretation
“the Applicant” means the individual who signs this Contract and agrees to be bound by its terms and includes a guardian of that individual if the individual is under 18 years of age.

The Applicant, hereby agree to be bound by the terms of this Contract with (insert name of Club) and the persons named and described in Schedule 1, hereinafter jointly and severally referred to as “the providers”. The providers agree to permit me to use their premises and facilities for Martial Arts, to instruct me in Martial Arts and related activities (“the service”) upon and subject to the following terms and conditions:

(a) Club Fees
The Applicant will pay on demand the prescribed or stated fees for the service. Such fees may be notified to the Applicant by letter or memorandum or by notice displayed in the provider’s premises or premises occupied by the provider or verbally.

(b) Medical Conditions
The Applicant warrants that he or she has not at any time suffered any blackout, seizure, convulsion, fainting or dizzy spells and is not presently receiving treatment for any illness, disorder or injury which would render it unsafe for the Applicant to take part in Martial Arts. The applicant further warrants that he/she has provided information on any and all pre-existing medical conditions.

(c) Exclusion of Applicant
The Applicant warrants that he or she has not at any time been excluded from Martial Arts by a medical practitioner or any person or entity including a Martial Arts Club.

(d) Rights of a Consumer
If the Trade Practices Act 1974 or similar state laws apply to this agreement then certain terms and rights may be implied into this contract which operates for the benefit of the Applicant. Under the provision of that legislation, those terms and rights, and any liability of the supplier flowing from them, cannot be excluded, restricted or modified by any provision of the contract.

PLEASE NOTE THE FOLLOWING:

If the Trade Practices Act 1974 or similar state laws operates so as to prevent the exclusion, restriction or modification of warranties otherwise implied by those laws then the liability of the offered for breach of those warranties is limited to:

(i) the re-supply of the Martial Arts instruction and related activities; or
(ii) the payment of the cost of having the Martial Arts and related activities supplied again.

(e) Waiver and Indemnity
In all other cases and except where inconsistent with the above, the Applicant for him/herself, his/her executors, administrators, dependents and other personal representatives, hereby absolves and indemnifies the providers and all their servants, agents, employees and other students or persons under the providers control (the “indemnified”) from all liability howsoever arising for injury or damage (including but not limited to the Applicants’ person, whether fatal or otherwise, property and personal belongings) however caused including by the negligence of the indemnified, arising out of or participating in Martial Arts or in connection with Martial Arts or in anyway caused by, or arising out of, any activity carried on by the indemnified. I, the Applicant, have been advised and understand that the practice of martial arts is potentially dangerous. I, the Applicant, agree to occupy and use the premises of the Black Crane Kung Fu Schools at risk to myself and release to full extent permitted by law SiSuk Paul Freiberg, The Black Crane Kung Fu Schools, and its agents, servants, contractors and employees from all claims and demands of every kind in of or resulting from any accident or damage to property or injury or death to myself while undertaking training in martial arts with the Black Crane Kung Fu Schools.

(f) Martial Arts done at Applicant’s own Risk
Any person training Martial Arts, or in activities connected with Martial Arts or participating in any activity carried on by this School are only allowed to do so on the distinct understanding that they do so entirely at their own risk.

(g) Martial Arts not to be taught by Applicant
The Applicant agrees that he/she is in no way qualified or authorised to teach martial arts from the Black Crane Kung Fu Schools publically or privately in any way whatsoever for personal, monetary or any form of gain whatsoever unless with the written authorization of SiSuk Paul Freiberg.

(h) Agreement to abide by the School Rules
I, the Applicant, agree that I will abide by the Black Crane Kung Fu Schools Codes of Conduct and agree and acknowledge that any failure to abide by rules of the Codes of Conduct may result in my expulsion from the School.

(i) Acceptance
Performance of the provider’s obligations under the contract may be affected by any one or more of the providers either jointly or severally.

(j) Governing Law
Any agreement entered into pursuant to this acceptance is to be governed by the laws of the State of Queensland and the Courts of the Commonwealth of Australia shall have exclusive jurisdiction to entertain any action in respect of any such agreement.

(k) Statement of Understanding
I, the Applicant have read, or have had read to me the above conditions and having understood the same, I consent to the activities proposed.

Applicant Signature

Date

Witness Signature

Date

GUARDIAN’S CONSENT: (for all persons under 18 years)

I hereby certify and decree that all the information contained in the declarations above is true and accurate.

Signature(Required)

Relationship to Applicant(Required)

Guardian Phone number(Required)

SCHEDULE 1

In addition to the Black Crane Kung Fu School, the providers in respect of this agreement include: (a) The President, Councilors and Ratepayers of Redland City Council. If a Council Hall is being hired or if not the principle representative of the venue being hired.
(b) The staff, instructors, venue providers, including but not limited to:
   (i) Birkdale School of Arts Hall Thorneside Hall
   (ii) Redland City Council
   (iii) The Black Crane Kung Fu Schools
   (iv) SiSuk Paul Freiberg