Event Waiver Event Waiver DUE TO INSURANCE REQUIREMENTS, GUESTS WILL NOT BE ADMITTED TO ANY EVENT WITHOUT A FULLY COMPLETED AND SIGNED PERMISSION SLIP (we do not share your information with anyone.) Parent/Guardian Information: First Name * Last Name * Email * Cell Phone * Guest/Minor Information: First Name * Last Name * Age * Date of Birth * Name of School Attending * For 18 Yrs. and Younger Which event type is this for? * Buddy WeekBirthday PartyGame NightOther Which event type is this for? Birthday Childs Name or Buddies Name * Assumption of Risk, Release of Liability & Photo/Video Authorization: The undersigned parent or legal guardian (“Applicant”) acknowledges and agrees as follows: Assumption of Risk & Indemnification Applicant understands that participation in any program, class, or event hosted by Encinitas Karate, Inc. involves inherent risks. Applicant agrees to release, indemnify, and hold harmless Encinitas Karate, Inc., its officers, directors, instructors, volunteers, staff, and contractors from any and all claims, liabilities, losses, or damages (including emotional distress) arising from participation in any Encinitas Karate program or event. In the event of an accident or emergency, Applicant authorizes Encinitas Karate, Inc. to obtain medical care deemed reasonably necessary for the minor participant and agrees to be financially responsible for all related costs. Photo & Video Authorization (Minors – California Compliant): Applicant grants Encinitas Karate, Inc. permission to photograph and/or record video of the minor child during classes, programs, or events hosted by Encinitas Karate, Inc. Such images or recordings may be used for educational, promotional, marketing, social media, and website purposes only. Only images in which the child’s face is clearly visible may be used, and notification will be provided only to the parent or legal guardian of that child: Encinitas Karate, Inc. agrees to use images in a respectful and appropriate manner consistent with California law. Opt-Out & Removal: Encinitas Karate, Inc. will promptly remove any image of a minor upon written request from the parent or legal guardian. If a parent or guardian previously signed a written photo use agreement and later requests removal of the child’s image from paid or printed advertising materials, the parent or guardian agrees to be responsible for any non-recoverable advertising or production expenses already incurred. Additional Terms: Encinitas Karate, Inc. will provide a separate written Photo Use Agreement for parent or guardian review and signature. Encinitas Karate, Inc. is not responsible for photos or videos taken or posted by other parents, spectators, bystanders, or third parties on social media or elsewhere. Guardian or Student Signature * signature keyboard Clear Date * Paragraph Text Text Paragraph Submit If you are human, leave this field blank.
