LOYOLA STUDENTS ONLY

 

                                                                    Loyola Ju-Jitsu Club
                                                                       Enrollment Form

PLEASE PRINT CLEARLY

Name:

Phone:

Email Address:

Please indicate your status:Student ___Grad. ___Alumni ___Staff ___FAC Member ____

I am paying by: Cash___ Check #_______ Money Order # __________ Evergreen _______

(Get a receipt)

Ju-Jitsu: Classes are taught during the spring and fall semester. Please see the schedule on the Loyola Ju-Jitsu club website for times and dates. Classes are $60.00 per semester.  Classes and 2 on campus seminars.  All dues are due by the end of the second week for beginners and for returning students.

                                                          ACKNOWLEDGEMENT OF RISK:

I, the undersigned, hereby acknowledge that I am fully aware that there are risks associated with my participation in the art of Ju-Jitsu. I also acknowledge that these risks may result in my being injured and accept and assume all such risks.

I, the undersigned assumes the responsibilities for such risk of injury while attending any Maru Martial Arts Dojo functions ,in or out of the dojo or while representing the school in any and all other related activities. Should the undersigned be injured, Maru Martial Arts its employers, sponsors, facility directors, officers or agents shall be released from all liabilities. I, the undersigned hereby wave, discharge and release Maru Martial Arts from any and all claims, demands, losses, damages and demands therefore on account of any injury. They are also released from any claims from the Undersigned, insurance carrier, heirs, hospital, doctors or any other persons or claims, losses or demands or any cost or compensation related to the injury. Maru Martial Arts will be found harmless from and against any and all claims that may arise resulting from my participation in all martial art/self-defense programs.

I, the undersigned, also acknowledge the risk of physical injury involved in randori. I also agree to the same terms set forth for martial arts and self-defense. I, the undersigned, have read, understood and signed a copy of the randori rules and waiver. I the undersigned do hereby acknowledge that I have read and or had explained to me these Rules, Regulations, Requirements, Dangers, Teaching methods, and Reasoning to those set policies.

I acknowledge that I have been advised to seek a physician's opinion regarding my physical fitness to participate in Ju-Jitsu.

With my signature I acknowledge that I have read and understood all the above contents of this waiver. I also understand that this is a legal document, and valid in a court of law.

Signature of participant: ______________________________________________Date: ________

If the student is under the age of 18, this agreement has to be signed by a parents orr guardian who has read and fully understands the terms and conditions of this agreement.

Signature of Participant______________________________________________ Date: _________

Signature of parent or guardian: ______________________________________ Date: _________

Signature of witness: ________________________________________________ Date: _________
                                                         Maru Martial Arts 

All checks must be made payable to "Loyola University Maryland." Get a receipt if you pay using your Evergreen card. Your payment or receipt must accompany this signed enrollment form. *No Refunds will be issued after the first week of scheduled class time.