LETTER
OF DISCLOSURE CONCERNING THE DANGERS THAT ARE ALWAYS
PRESENT
DURING THE STUDY OF AIKIDO, JUDO, JYODO AND OTHER SPORTS.
1. JUDO AND AIKIDO ARE ARTS THAT
REQUIRE FALLING BY THE PRACTIONERS AND ARE DANGEROUS TO THE PRACTIONERS BECAUSE
THEY ARE BODY CONTACT MARTIAL ARTS AND SPORTS
ANY PERSON STUDYING THESE ARTS SHOULD EXPECT THAT INJURY OR DEATH CAN
AND SOMETIMES DOES OCCUR. SEE #11 INITIAL____________
2. JYODO IS A WEAPONS MARTIAL ART AND
IS A DANGEROUS ART BECAUSE DANGEROUS
WEAPONS ARE USED IN TRAINING EXERCISES. ACCIDENTS DO OCCUR AND CAN BE SERIOUS.
INJURY AND DEATH CAN OCCUR. SEE #11 INITIAL___________
3. JUDO, AIKIDO AND JYODO
ARE ARTS THAT REQUIRE AUTOMATIC REFLEX APPLICATION OF TECHNIQUES. THERE ARE
MOVEMENTS IN EVERY TECHNIQUE WHEN NO ONE
CAN MAINTAIN SAFE CONTROL OVER A
TRAINING PARTNER. DURING THESE MOMENTS INJURY AND DEATH CAN AND HAS OCCURRED.
SEE #11 INITIAL_______
4. NO MARTIAL ARTS PRACTICE SURFACE IS SAFE. IF IT
IS FIRM ENOUGH TO WALK ON IN AN ATHLETIC MANNER IT IS TO HARD TO FALL ON. IF IT
IS SOFT ENOUGH TO FALL SAFELY ON IT IS TO SOFT TO WALK ON AND MOVE IN AN ATHLETIC MANNER. NO SAFE
SURFACE EXISTS AND INJURY AND DEATH DOES OCCUR. SEE #11 INITIAL_______
5. IT IS IMPOSSIBLE TO
TEACH A STUDENT TO FALL SAFELY AT ALL TIMES, BECAUSE FALLING IS A REFLEXIVE
RESPONSE ART AND THEREFORE TIME BECOMES IMPORTANT. IF THERE IS ENOUGH TIME TO
FALL SAFELY ONE WILL FALL SAFELY. IF THERE IS NOT ENOUGH TIME THE
FALL WILL BE UNSAFE .SEE#11 INITIAL________
6. ARMLOCKS,
LEGLOCKS,SHOULDERLOCKS, WRISTLOCKS,SPINELOCKS, NECKLOCKS, FINGERLOCKS, LOCKS TO
EVERY JOINT OF THE BODY, IN ADDITION TO THE APPLICATION OF PRESSURE
TO EVERY EXPOSED NERVE ENDING IN THE BODY ARE TAUGHT. THIS INCLUDES ATTACK TO THE EYES. THE
PRACTICE OF THESE TECHNIQUES CAN CAUSE
SERIOUS INJURY AND DEATH.SEE#11 INITIAL_______
7. DURING OUR CLASSES
AND PRACTICES VARIOUS GAMES ARE PLAYED TO ENHANCE THE TRAINING PROCESS AND IT
IS SOMETIMES NECESSARY TO PRACTICE OTHER MARTIAL ART SYSTEMS IN ORDER TO TEACH
A PROPER DEFENSE AGAINST
THESE OTHER ARTS.
SERIOUS INJURY AND DEATH CAN AND DOES OCCUR DURING THIS TRAINING. SEE#11
INITIAL__________
8. CLIMBING APPARATUS ARE
USED DURING TRAINING. A FALL FROM THIS APPARATUS CAN CAUSE SERIOUS INJURY AND
DEATH. SEE#11 INITIAL__________
9. A PHYSICIAN'S
EXAMINATION SHOULD PRECEDE ENROLLMENT. SEE #11 INITIAL__________
10. JUDGMENTAL ERRORS ARE
A PART OF THE MARTIAL ARTS AND ALL TEACHERS
AND STUDENTS WILL AND DO MAKE JUDGMENTAL ERRORS REGULARLY.
BECAUSE THE DYNAMIC ATHLETIC
REQUIREMENTS OF ALL MARTIAL ARTS AND THE GAMES PLAYED IN THE SCHOOL MAKES
COMPLETE CONTROL IMPOSSIBLE AND A COMPLETELY SAFE ATMOSPHERE IMPOSSIBLE DURING
REGULAR CLASS AND OR COMPETITIVE ACTIVITIES
ADVANCED PREDICTION OF DANGEROUS SITUATIONS IS ABSOLUTELY IMPOSSIBLE.
SEE#11 INITIAL__________
11. JUDO, AIKIDO, AND
JYODO AND ALL GAMES AND ALL MARTIAL ARTS WITHOUT EXCEPTION ARE VERY DANGEROUS.
IN THE PRACTICE OF THESE ARTS AND GAMES EVERY BONE ALL SOFT TISSUE, EVERY
ORGAN, AND EVERY PART OF THE HUMAN BODY CAN BE SERIOUSLY INJURED AND DEATH AND
PARALYSIS CAN AND DO SOMETIMES OCCUR.
INITIAL_________
12. ONE OF THE GOALS OF AIKIDO IS TO TEACH SELF DISCIPLINE. IT MAY THEREFORE BE NECESSARY FOR THE INSTRUCTOR TO DISCIPLINE STUDENTS (ESP. CHILDREN) PARTICIPATING IN CLASSES.
VOLUNTARY
ASSUMPTION OF RISK AND DANGER
HAVING THOROUGHLY AND
COMPLETELY READ AND UNDERSTOOD THE ABOVE DISCLOSURE OF THE DANGERS THAT ARE
PART OF THE STUDY OF ALL MARTIAL ARTS AND SPORTS. I VOLUNTARILY ASSUME THOSE
RISKS FOR MYSELF /MY CHILD/ OR CHILDREN IN ORDER THAT I/HE/SHE WILL BE ALLOWED
TO PARTICIPATE IN THE TRAINING OF THE MARTIAL ARTS AND SPORTS AND ALL GROUP ACTIVITIES THAT I/ MY CHILD MIGHT HAVE
THE OPPORTUNITY TO PARTICIPATE IN WHILE STUDYING AND TRAINING IN THESE ARTS AND
SPORTS.
I AGREE FOR MYSELF/MY
HEIRS, EXECUTORS AND ADMINISTRATORS TO RELEASE AND FOREVER DISCHARGE ANY AND
ALL RIGHTS AND CLAIMS FOR DAMAGES WHICH I MAY HAVE OR WHICH MAY HEREAFTER OCCUR
AND I AGREE TO HOLD HARMLESS ALMOST
HEAVEN AIKIDO/JUDO ACADEMY – AKA TOMODACHI DOJO, JOHN C. ALLEN, AND/OR ANY AND
ALL OF THEIR OFFICERS, COLLEAGUES, STUDENTS, AND OR ASSOCIATES, AND ALL
ATHLETIC CLUBS ,TEACHERS, STUDENTS, ASSOCIATE MEMBERS, MEMBERS OF OTHER MARTIAL
ART ASSOCIATIONS ACTIVE AND INACTIVE AND ALL VISITORS , FOR ANY DAMAGES WHICH
MAY BE SUSTAINED AND SUFFERED BY ME/MY CHILD IN CONNECTION WITH MY ASSOCIATION
WITH OR ENTRY IN THE ABOVE CENTER OR WHICH MAY ARISE OUT OF MY TRAVELING TO,
PARTICIPATING IN AND RETURNING FROM SUCH ACADEMY/DOJO.
_______________/________________________________________________________________________________________
DATE STUDENT’S SIGNATURE
PRINT NAME
___________________________________________________________________________________________
PHONE #_______________________________________________________________________________________________
DATE OF
BIRTH________________________________________________________________________________________
ADDRESS______________________________________________________________________________________________
______________________________________________________________________________________________
E-MAIL ________________________________________________________________________________________________
PARENT’S SIGNATURE IF UNDER 18
____________________________________________________________________
PLEASE LIST ANY MEDICAL CONDITIONS WE SHOULD BE AWARE OF___________________________________
________________________________________________________________________________________________________
CONTACT PERSON AND NUMBER IN CASE OF
EMERGENCY__________________________________________________________________________________________
_______________________________________________________________________________________________________
WHY DO YOU WANT TO STUDY MARTIAL
ARTS?________________________________________________________
HOW DID YOU HEAR ABOUT US?
_______________________________________________________________________
WELCOME TO ALMOST HEAVEN AIKIDO/JUDO
ACADEMY !