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Welcome to TKA!

Registration Form

Student Information

Guardian Information

Payment Information

Waiver and Liability Agreement

Please read the following carefully; under this agreement you are relinquishing certain rights and accepting certain obligations: Injury Waiver: Student, the parent, or legal guardian on behalf of the student, acknowledges and is fully cognizant of all the inherent dangers in connection with the execution of Martial Arts and acknowledges that the execution of the Martial Arts requires physical exertion and contact, and realize that there is a risk of physical injury which may be incurred while engaged in this activity. Student, parent, or legal guardian on behalf of the student, hereby waives any and all claims for any physical injury in connection with the training at the school and expressly assumes the risk of all dangers or injury inherent to the Martial Arts. I, the student, acknowledge receiving a copy of this agreement. I, the student or the parent on behalf of the student, understand that under the terms of this agreement, the school obligates itself to furnish me with competent instruction and suitable facilities for teaching lessons. All class lessons are supervised by qualified personnel trained in the procedures and traditions of the martial arts. The student hereby represents that he or she is physically fit to receive and participate in the prescribed course of instruction. The student agrees to faithfully comply with all the rules and regulations of the school and the traditions of the Martial Arts. The regular hourly rate is $120.00 per hour; however, a substantial discount has been provided me by virtue of enrolling in a regular course. I, the student, understand that my tuition is arranged to be made in monthly installments or 1-3 lump sums and is not affected by my training schedule and/or attendance. Square is the financial agent representing the school with the authority to enforce the agreement. Any modifications, changes, amendments or cancellations of the student enrollment must be in writing. No oral amendments or modifications are to be made to the student enrollment agreement. I further understand that failure to complete the training does not relieve me of my obligation to pay the tuition in full. All inquiries are to be directed to Taichi Kung-Fu Academy. Protective Equipment and Weapons. The student understands and agrees to observe all training rules and regulations of the school, which include the use of specific protective equipment and weapons approved and purchased through the school. Protective equipment and weapons, required by the school, will largely eliminate the possibility of accident or injury; however, the school does not warrant protective equipment or weapons of any kind and the student acknowledges the potential for bodily injury even with the use of protective equipment and weapons. The student understands it is his or her responsibility to purchase protective equipment and weapons. NOTICE OF CONSUMER RIGHTS: •You may cancel this agreement without penalty or further obligation within three (3) days from the date of this agreement. Notice of cancellation shall be in writing and mailed to the school by registered or certified mail. A late charge of fifteen dollars ($15.00) will be assessed for any payments seven days past due. I, the student, understand my rights and the cancellation policy as stated on this form. •If you move your primary residence more than 25 miles from the school facility, this membership can be transferred free of charge to any Taichi Kung-Fu Academy. In the case where a school cannot be provided, cancellation under this section requires written proof of new permanent address, phone number, name and address of new employer and requires 30-day advance written notice. A residence investigation will then be conducted. •If you become disabled for at least six (6) months during the membership terms and that disability is confirmed in writing by a physician, you have a right to an extension and/or termination of the contract. •There are no refunds, whatsoever. •This Notice of Consumer’s Rights is an integral part of the Application and Contract for Membership. Photo Release: I hereby grant Taichi Kung-Fu Academy permission to use my or my child’s likeness in a photograph in any and all of its publications, including website entries, without payment or any other consideration. I understand and agree that these materials will become the property of Taichi Kung-Fu Academy and will not be returned. I hereby irrevocably authorize Taichi Kung-Fu Academy to edit, alter, copy, exhibit, publish or distribute this photo for purposes of publicizing Taichi Kung-Fu Academy’s programs or for any other lawful purpose. In Addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph. I hereby hold harmless and release and forever discharge Taichi Kung-Fu Academy from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

$100 One Time Registration Fee Includes Free Uniform, shoes and belt

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