directions

IMPORTANT!

STUDENT RELEASE FOR KANZI SCHOOL OF MARTIAL ARTS

*****Please print this page, fill out completely, and bring the form to your first class******

The student is aware in making this agreement to participate in training in the martial arts, specifically in kickboxing and self-defense, that elements of this training are physically demanding and potentially dangerous, and with this knowledge agrees to indemnify and hold harmless from all losses caused by accident or injury the Sensei, her assistants, or any third parties who may be students in the same class or seminar or who are students with the Sensei, in the event that the enrollee or the said third party is injured in any way during the proper performance and execution of techniques or instruction provided in this training. Initial Here________
   This release shall also include any landlord or leaseholder of any training facility in which training is conducted. I also agree that the terms hereof shall serve as a release and assumption of risk for my heirs, executors and administrators, and for all members of my family, including any minors. Initial here______________
   The enrollee attests that he/she is in good physical condition and has no known or suspected medical conditions that would preclude vigorous physical activity and has had a physical exam by a qualified health professional within the last year. Initial here__________
   As part of the consideration for participation, the enrollee acknowledges and assumes all these risks and wishes to enroll in this course of instruction. Initial here_______________

Print Name: ___________________________________

Age: _________Birthdate: ______________ Height:_________Weight:___________

Street Address:_________________________________________________________________

City: _____________________ State: _______ Zip Code: _____________

Phone #: ____________________________________________

Contact in case of emergency: _________________________

Contact's Ph: ________________________

Medical Coverage/Insurer:________________________________________

*Signature: Date: _______________________________________________
_____________________________________

EQUIPMENT

MOST GEAR IS PROVIDED FREE OF CHARGE. THIS INCLUDES HEADGEAR, FOOT PADS, SHIN PADS, GLOVES, AND CHEST PROTECTORS

o MANDATORY Safety Equipment

 Mouth Piece.

 Headgear

 Foot Pads- All divisions/rule styles must wear footgear that covers the toes.

 Shin Pads.

 Gloves: 16 ounce Boxing Gloves will be used for competition. (Open TaeKwonDo style hand protection will be used in regular KMA classes.

The following should be provided by the student:

Mouth Guards are mandatory. If you can't afford one, there are a limited number available for free. Standard hand-wraps should be worn by all students/competitors. Face guards are optional.

DRESS CODE: Full-length, long Karate pants are mandatory.

(Note: KMA students will wear full karate uniforms. Sleeveless tee-shirts, worn underneath so the heavier uniform top can be removed for comfort, are also acceptable. Unlike other schools, wherein only the Sensei is allowed to wear black, the standard uniform of KMA students will be black, reflecting the worth of the mature student and fostering an atmosphere of equality. Sleeveless tee shirts should also be black.) A limited number of uniform tops are available to borrow for those who can't afford them.

Uniforms and protective gear can be purchased inexpensively from Martial Arts Mart, at http://store.martialartsmart.net/index.html. We suggest the complete sparring set in black (headgear, mouth-guard and case, hand protection and foot protection) combined with the foam shin pads sold separately.