SANTA MONICA DOJO IN-PERSON CLASSES PRE-REGISTRATION
Let's train! Thank you for pre-registering for in-person dojo training!

Community Karate Foundation, Inc. dba Santa Monica Dojo, is committed to providing a safe environment for participants and staff, and will comply with all local, state and federal guidelines applicable at this time.

New COVID-19 check-in procedures are in place for the safety and protection of all participants and staff. Proof of COVID-19 full vaccination (14 days after final vaccine shot), symptom screening, and temperature checks are required prior to entry. Masks are highly recommended. All participants are to enter from the front door. Please observe social distancing markers. If you or your child do not meet these requirements or have COVID-19 symptoms, please contact us at info@communitykaratefoundation.org for alternative arrangements.

Updated 3-15-2023
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Email *
Participant name: *
Parent/Legal Guardian's name of Participant (if minor):
 Parent/Legal Guardian Emergency Contact Number
I.  COVID-19 SYMPTOM SCREENING QUESTIONS

ON THE MORNING OF YOUR CLASS, IF YOU AND/OR YOUR CHILD ANSWERED “YES” TO ANY OF THESE QUESTIONS, DO NOT COME TO THE DOJO AND QUARANTINE AT HOME FOR 14 DAYS. YOU WILL NOT BE ALLOWED TO ENTER.

- In the past 48 hours, have you had a fever (100.4°F) or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and/or diarrhea?

- In the past 14 days, have you been in close contact with anyone confirmed to have COVID-19 or showing COVID-19 symptoms?

- Are you currently waiting on the results of a COVID-19 test?

- Are you isolating or quarantining because you tested positive for COVID-19 or are worried that you may be sick with COVID-19?
II.  IN-PERSON TRAINING REQUESTS (except holidays)
This pre-registration request form can be submitted up to 7 days before your class date and time, and is good for the selected dates and class times. Be sure to arrive within 15 minutes before your class to complete the COVID-19 check-in procedures.

Youth classes are recommended for ages 5 - 12 years old. Adult classes are recommended for ages 13 years and older. Beginner rank is 9th - 7th kyu (white, yellow, orange belt). Intermediate rank is 6th - 4th kyu (green, purple belt). Advanced rank is 3rd kyu and higher (brown, black belt).

This schedule is subject to change. Please contact info@communitykaratefoundation.org for holiday closures.
Please indicate the first class date that you or your child would like to attend: *
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Please select the classes that you or your child would like to attend: *
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III.  PARTICIPATION, RELEASE AND WAIVER AGREEMENT

IN CONSIDERATION for being permitted to participate in, or granted use of, “Community Karate Foundation, Inc., DBA Santa Monica Dojo” facilities, services, and programs, and/or for participants listed below to so participate or use, the undersigned, on behalf of herself, herself or themself, on behalf of such participating minors and adults, and on behalf of our current or future personal representatives, heirs, and assigns (hereinafter, collectively, "the UNDERSIGNED"), and intending to be legally bound, does hereby acknowledge and agree as follows:

1. “Participation” is to be construed broadly and includes, but is not limited to, the observation of, or participation in, any Santa Monica Dojo program, service, or activity (academic, athletic, social, service, or otherwise), whether on Santa Monica Dojo leased, licensed, utilized by, or affiliated with Santa Monica Dojo in any manner, whether held in-person or hosted online.

2. Novel coronavirus (''COVID-19") infections have been confirmed throughout the United States, including in Los Angeles County and the City of Santa Monica. Santa Monica Dojo has taken certain steps to implement applicable, recommended federal, state, and municipal guidance and protocols for slowing the transmission of COVID-19, including, without limitation, the implementation of its “Santa Monica Dojo COVID-19 Procedures” (hereinafter “Plan”) for the resumption of in-person training.

3. UNDERSIGNED has received and reviewed the Plan and agrees that Santa Monica Dojo may revise the Plan at any time based on updated recommended federal, state, and municipal guidance and protocols. Participation in any Santa Monica Dojo program, service, or activity is entirely voluntary, and the UNDERSIGNED expressly agrees to comply with the Plan, and any updates or modifications to the Plan, during any period of participation in or use of Santa Monica Dojo facilities, services, and/or programs (other than any exclusively online services and programs).

4. Assumption of Risk

The UNDERSIGNED has inspected and carefully considered the premises, facilities and equipment designated for use in the subject Santa Monica Dojo program(s), service(s), or activity (ies) and finds and accepts them as being safe and reasonably suited for the use or participation by the UNDERSIGNED and/or such participating minors. The UNDERSIGNED further acknowledges and agrees that participation in and use of the premises, facilities and equipment designated for use in the subject Santa Monica Dojo program(s), service(s), or activity (ies), may not always allow for social distancing of 6 feet. The UNDERSIGNED fully understands, appreciates, and accepts that, despite Santa Monica Dojo's reasonable efforts to mitigate COVID-19 related exposures, the risk of exposure to COVID-19 cannot be eliminated, and could result in quarantine requirements, serious illness, disability, and/or death.

The UNDERSIGNED acknowledges that participation in Santa Monica Dojo programs, services, or activities and/or use of Santa Monica Dojo premises, facilities and equipment involves an inherent risk of personal injury and/or illness to the participant. The UNDERSIGNED voluntarily agrees to assume all risks of personal injury and/or illness, including quarantine requirements, serious illness, disability, and/or death.

The UNDERSIGNED acknowledges that participation in athletic endeavors, in particular, involves an inherent risk of bodily injury, including, in some instances, disability and/or death. The UNDERSIGNED voluntarily agrees to assume all such risks.

5. Waiver of Liability and Indemnification

The UNDERSIGNED, on her, his or their behalf and on behalf of such participating minors, hereby WAIVES, RELEASES, DISCHARGES, HOLDS HARMLESS, and INDEMNIFIES, Community Karate Foundation, Inc. DBA Santa Monica Dojo, together with its directors, officers, employees, volunteers and agents (collectively, “Santa Monica Dojo Releasees”), from any and all liability for personal injury and/or illness (including quarantine requirements, serious illness, disability, and/or death) impacting the UNDERSIGNED and/or her/his/their participating minors and participants, arising out of or relating to (i) participation in any Santa Monica Dojo program, service, or activity, or (ii) use of Santa Monica Dojo premises, facilities or equipment, even if such personal injury and/or illness occurs as a result of the negligence, active or passive, gross or ordinary, of Santa Monica Dojo or any of the Santa Monica Dojo Releasees.

The UNDERSIGNED acknowledges and agrees that this Participation, Release and Waiver Agreement is a voluntary, arms’ length agreement involving purely private interests, and not any matters of interest to the public or any governmental entity.

THE UNDERSIGNED expressly agrees that this Participation, Release and Waiver Agreement shall be interpreted under the laws of California, and is intended to be interpreted as broadly as is permitted by law and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

6. Photographic and/or Videotaping Agreement and Release

The UNDERSIGNED, on her, his or their behalf and on behalf of such participating minors, acknowledges and agrees that television, motion picture, web production, or photography will occur during participation in any Santa Monica Dojo program, service, or activity (academic, athletic, social, service, or otherwise). The UNDERSIGNED understands that in that context, videotapes, motion pictures, digital pictures or movies, audio recordings, and/or photographs (all of which are referred to as ‘Pictures’) of the named participating adult and minor named below will be taken.

The UNDERSIGNED hereby consent to the Pictures of the named participating adult and minor that will be produced by Santa Monica Dojo on the date of participation and in the location of participation. The UNDERSIGNED verify their authority as a consenting adult and legal guardian to make such agreements on behalf of the named minor. The UNDERSIGNED further grant Santa Monica Dojo, its agents or assigns, exclusively and perpetually throughout the world and elsewhere, all rights of every kind, whether known or unknown, for the unlimited use both now and in the future of such Pictures of the named minor. I understand that neither I nor the named minor will receive monetary compensation for participating in this project either now or in the future. I do hereby release and hold harmless Santa Monica Dojo, its officers, employees, volunteers, agents, or assigns from any claims.

IV.  PARTICIPANT or PARENT/LEGAL GUARDIAN ELECTRONIC SIGNATURE *
A copy of your responses will be emailed to the address you provided.
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