Yushinkan: New Member Form and Waiver

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All fields are required. In order to train at Yushinkan, this form, including clicking acceptance of the COVID-19 Policy and the Training Waiver, must be completed.

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First Name *

Last Name *

Email Address *

Address

Phone number *

Emergency Contact: Name *

Emergency Contact: Phone Number *

Prior martial arts experience *

How did you hear about Yushinkan? *

Are there any significant medical conditions that would affect your practice of martial arts? If yes, please describe.

What are you hoping to achieve through the study of martial arts at Yushinkan? *

YUSHINKAN COVID-19 POLICY

1. All members training in-person must be fully vaccinated against COVID-19. Booster is recommended.

2. Proof of vaccination (card or Excelsior Pass) must be provided.

3. If you test positive, inform the dojo immediately. Refrain from in-person training. You may be able to return to practice within 7-10 days, as long as your symptoms are improving/ have resolved (discuss with Kong Sensei).

4. If you develop fever, cough, congestion, vomiting, diarrhea, or other flu-like symptoms, inform the dojo immediately. Refrain from in-person training. You may be able to return to practice within 7-10 days, as long as your symptoms are improving/ have resolved (discuss with Kong Sensei).

5. If you have had COVID-19 exposure to a close contact (Household), you must wear a mask while training for 7-10 days (discuss with Kong Sensei).

6. You assume the risk of exposure to SARS COV2/COVID-19, the resultant disease, and all related disease morbidity and mortality by engaging in in-person training at the dojo, or at dojo sponsored events.

By clicking this box, I attest that I have read, understand, agree with, and can abide by the Yushinkan COVID-19 Policy.

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YUSHINKAN TRAINING WAIVER

I am aware that the practice of martial arts involves physical contact and has an inherent risk of serious or even fatal injuries, as well as a risk of exposure to infectious diseases, such as COVID-19, and the resultant morbidity and mortality that may arise from such exposure. I understand these risks. I present myself as being physically and mentally capable to engage in martial arts training, and forever release Yushinkan LLC, and any and all of its representatives from all liability for injuries, illness, morbidity, or mortality that I may sustain while engaged in training at Yushinkan, at Yushinkan sanctioned events, or while receiving instruction from any and all of its representatives.

By clicking this box, I attest that I have read, understand, agree with, and can abide by the Yushinkan Training Waiver.

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