Isshin-Aiki  Family Reunion
Rules and Regulations
Fall Camp | Sept 26-28, 2008

MSISSHINRYU-NO-MEGAMI

Isshinryu

DISCLAIMER

1. VOLUNTARY PARTICIPATION. I have asked to participate in this Karate Training Camp. I understand that I will be participating in a semi contact activity and agree to do so at my own wish and discretion.

2. WAIVER OF CLAIM. I waive any claim I may have against any Isshinryu Karate club, instructor, student, Camp John I Hay staff, or Camp John I Hay, this karate camp, the instructors of this camp, or other participants of this camp for any injury, damage, loss, sickness, or even death arising out of my participation in the camp's activities both scheduled and voluntary.

3. PHYSICAL CONDITION. I represent that I am free from any physical condition that would cause my participation in the camp to be inadvisable.

4. MEDICAL ATTENTION. If I am injured or become ill while participating in this camp, I give permission for the Karate Camp Instructors, designated First Aid personnel, or Camp Staff to secure necessary medical assistance for me at my expense. I waive any claim I may have against anyone who may furnish me medical assistance under such circumstances.

5. UNDERSTANDING. I understand that this Karate Camp furnishes no insurance for medical coverage or other loss I may have; and that it is my responsibility to obtain my own medical insurance.

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DATE                                 PRINT NAME

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SIGNATURE OF CAMPER

If camp member is under 21 years of age, both parents must sign this portion or guardians if both are available.

We are the parents of __________________________, a minor who wishes to participate in the Karate Camp. By signing below, we give our permission for our child to participate under conditions 1 through 5 stated above.

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PRINT NAME OF PARENT OR GUARDIAN SIGNATURE
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PRINT NAME OF PARENT OR GUARDIAN SIGNATURE




 

 



 

Rules and Regulations

PERSONAL INFORMATION SHEET

NAME________________________ AGE____ DATE OF BIRTH__________________
ADDRESS______________________________________________________________
PHONE NUMBER HOME___________________________ WORK________________

CURRENT RANK_______________________ DATE OF RANK___________________

NAME OF SENSEI_____________________ SENSEI'S PHONE__________________

OTHER SYSTEMS STUDIED_______________________________________________
TIME IN EACH___________________________________________________________
RANKS_________________________________________________________________
CURRENT OCCUPATION__________________________________________________
CIVILIAN OR MILITARY SKILLS_____________________________________________
________________________________________________________________________



EMERGENCY NOTIFICATION PHONE NUMBERS:
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________________________________

DOCTORS NAME______________________________________
DOCTORS PHONE NUMBER_____________________

WHOM SHOULD WE NOTIFY IF PARENTS CANNOT BE REACHED?_____________
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Please return this form with your training fee. Thank You and Happy Camping!