In consideration of the acceptance of the above named applicant for the instruction in the martial arts, and also recognizing that there are risks involved in practicing, studying, or demonstrating the above mentioned subjects, I, the undersigned parent or guardian, hereby now and forever, fully release and discharge and agree to save, indemnify, and keep harmless the WA SHITO RYU ACADEMY their officers, agents, employees, instructors, members and authorized guests from all liability, claims, judgments or demands for damages arising from damages or injury of the applicant named above or his (her) property occasioned by the acts of negligence, or failure of act of the WA SHITO RYU ACADEMY, their officers, agents, employees, instructors, members, and authorized guests, and I further agree I will never institute any suit or action at law, or otherwise, against the WA SHITO RYU ACADEMY, their officers, employees, agents, instructors, members, and authorized guests on account of or arising out of damage, loss or injury to applicant named above. I further state that I am the parent or legal guardian of applicant named above and I understand that the terms herein are legally binding and not a mere recital and that I sign this document as my own free act.
I HAVE FULLY INFORMED MYSELF OF THE TERMS AND CONDITIONS OF THIS AFFIRMATION AND RELEASE BY READING IT BEFORE I SIGNED IT. I have had applicant named above examined by a physician to assure myself, and I assume the responsibility of physical fitness and capability to perform under the normal conditions of the course of instruction mentioned above, and applicant named above is physically fit as attested to by the aforementioned medical examination, and I agree to maintain at all times a policy of medical and accidental insurance for said minor child.