Clone of Mixed Martial Arts Monthly Membership Payment

Full Name*

First NameLast Name

Parent Or Guardian Name If Student Is Under 18

First NameLast Name

Names Of Others Students If Applicable (Not Required)

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E-mail*

example@example.com

Phone Number*

Which location Would You Like To Train?

WestmontOak BrookBoth Locations

What Style Would You Like To Train In ?*

Strekydo Self Defense Jiu jitsu

$20.00 for each month

STS Hapkido

$30.00 for each month

Taekwondo

$ Free for each month

Muay Thai

$ Free for each month

For and in consideration of being allowed to participate in online video or live fitness classes and conditioning activities at International Self Defense Academy LLC Including, but not limited to, aerobic/mixed martial arts fitness exercises, weighted resistance exercises, boxing, Muay Thai, and kickboxing, punching and/or kicking focus mitts, running, and calisthenics such as pushups, pull ups and sit-ups,
the undersigned Participant does hereby release International Self Defense Academy LLC , its Instructors, officers, and employees from any liability which may or could occur by reason of any personal injury or property damage suffered by me regardless of the cause or alleged cause of such personal injury or property damage.

I understand that I will be voluntarily participating in activities which may expose me to some level of risk or injury, and I represent that I am aware of the nature of these activities and agree to accept all risks associated with my participation in these activities.

I represent that I am in good physical health, and that unless I notify International Self Defense Academy LLC in writing that I am unable to participate in an activity due to some physical or mental considerations, I will be allowed to participate in all activities of International Self Defense Academy LLC. Furthermore, in consideration of International Self Defense Academy LLC allowing the me to participate in these activities, I agree to hold International Self Defense Academy LLC harmless and indemnify it and its directors, instructors, officers, and employees against loss (including reasonable attorney= fees) from any and all claims of negligence, demands, rights, or causes of actions of any kind or nature that may hereafter at any time be made or brought by me or on my behalf for any known or unknown, foreseen and unforeseen bodily or personal injuries, damages to property and consequences thereof which may be sustained by me as a direct or indirect result of participating in the aforementioned activities at International Self Defense Academy LLC.

PLEASE READ BEFORE AGREEING

By signing below, I acknowledge that I understand that I am entitled to have an attorney of my own choosing to review this release prior to signing. I have read the foregoing release in its entirety and understand that I am signing a complete and perpetual release to any and all claims of negligence as defined above resulting from my participation in the activities described above at International Self Defense Academy LLC. I understand that I can cancel my subscripton at anytime by contacting International Self Defense Academy LLC, and I acknowlege that I am at least the age of 21 years old.

Governing Law. This Agreement shall be governed by the laws of the Illinois.

Signature

MARTIAL ARTS CLASS REGISTRATION

WAIVER