Signup

Mid-Missouri Judo Release Form

Name: {name}

Address: {address}

Phone Number: {phone}

Date of Birth: {dob}

My signature below (or the signature of a parent or legal guardian) indicate that I understand and accept the following terms and conditions. Please initial each section indicating you agree to it.

Training Facility Rules

The training facility includes the training room (dojo), rest rooms, and other grounds of 4250 E Broadway facilities.

Equipment

No watches, rings, bracelets, necklaces, piercing, etc. that may injure a student shall be worn during training. If such objects cannot be removed, they will be taped for safety. Uniforms are required and can be purchased through the club, or online. If purchased online – it must meet the international standard for Judo Gi. Uniforms shall be worn at all times.

USA Judo

Membership is required in order to maintain our club insurance through USA Judo. Forms are available through your instructor, or by visiting usjudo.org. If you are already a USA Judo member, please provide your USA Judo number on your application form

Training and randori

Judoka will keep their finger and toe nails trimmed in order to prevent injury to others.

Unsportsmanlike conduct, profanity, obscene gestures or actions, and use of excessive force or roughness are strictly forbidden.

No participant will begin or continue training with an open, exposed, bleeding, or seeping wound. All wounds and their dressings are subject to inspection and approval by the instructors.

Miscellaneous

All participants are expected to address one another with respect and courtesy. When addressing others, participants will use “Ma’am” or “Sir.”

Students have a responsibility to conduct their behavior both within the training facility and the community at large with the proper courtesy, integrity, respect, and etiquette.

Cigarettes, chewing tobacco, alcohol, and drug use are prohibited within the training facility. In addition, chewing gum, food, and drink items are not allowed in the training area.

Rule violations, injuries, safety hazards, or actions unbecoming a student of Judo shall be reported immediately to an instructor or senior student.

Above all, students must seek to help each other learn and hold high regard for the safety and welfare of all. When your training partner or competition opponent submits to a technique, either verbally or by tapping twice, you must immediately release them. Transgressions of this expectation will not be permitted.

Notice of Filming and Photography

I, the undersigned, acknowledge that when I enter a Mid Missouri Judo event or program, I enter an area where photography, audio and video recording may occur. By entering the event premises, I consent to interview(s), photography, audio recording, video recording and its/their release, publication, exhibition, or reproduction to be used for news, webcasts, promotional purposes, telecasts, advertising, inclusion on websites, social media, or any other purpose by Mid Missouri Judo and its affiliates and representatives. Images, photos and/or videos may be used to promote similar Mid Missouri Judo events in the future, highlight the event and exhibit the capabilities of Mid Missouri Judo. I release Mid Missouri Judo, its officers and employees, and each and all persons involved from any liability connected with the taking, recording, digitizing, or publication and use of interviews, photographs, computer images, video and/or sound recordings. By entering the event premises, I waive all rights I may have to any claims for payment or royalties in connection with any use, exhibition, streaming, webcasting, televising, or other publication of these materials, regardless of the purpose or sponsoring of such use, exhibiting, broadcasting, webcasting, or other publication irrespective of whether a fee or admission or sponsorship is charged. I also waive any right to inspect or approve any photo, video, or audio recording taken by Mid Missouri Judo or the person or entity designated to do so by Mid Missouri Judo

Mid Missouri Judo’s Waiver of Liability Relating to Coronavirus/COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization.  COVID-19 is reported to be extremely contagious. The state of medical knowledge is evolving, but the virus is  believed to spread from person-to-person contact and/or by contact with contaminated surfaces and objects,  and even possibly in the air. People reportedly can be infected and show no symptoms and therefore spread  the disease. The exact methods of spread and contraction are unknown, and there is no known treatment, or cure for COVID-19. Evidence has shown that COVID-19 can cause serious and potentially life threatening illness and even death. 

Mid Missouri Judo cannot prevent you [or your child(ren)] from becoming exposed to, contracting, or spreading COVID-19 while participating in Mid Missouri Judo’s activities or entering its premises. While we are taking precautions, It is not possible to fully prevent against the presence of the  disease. Therefore, if you choose to utilize Mid Missouri Judo’s services and/or enter onto Mid Missouri Judo’s premises you may be exposing yourself to and/or increasing your risk of contracting or spreading COVID-19. 

ASSUMPTION OF RISK 

I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of  contracting COVID-19 for myself and/or my children in order to utilize Mid Missouri Judo’s services and  enter Mid Missouri Judo’s premises. These services are of such value to me [and/or to my children,] that  I accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to utilize Mid Missouri Judo’s services and premises. 

WAIVER OF LAWSUIT/LIABILITY 

I hereby forever release and waive my right to bring suit against Mid Missouri Judo and its owners,  officers, directors, managers, officials, trustees, agents, employees, or other representatives in connection  with exposure, infection, and/or spread of COVID-19 related to utilizing Mid Missouri Judo’s services  and premises. I understand that this waiver means I give up my right to bring any claims including for personal  injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence  and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen. 

CHOICE OF LAW 

I understand and agree that the law of the State of Missouri will apply to this contract. 

I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND  KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE: 

Name of Member: {name}

Date: {sign_date}