New and Renewing Member's Once you have completed and submitted this form, you will automaticly go to our Members Payment Options page which will allow you to make payment via any major credit card type or by your PayPal account with a secure shopping basket, if you have any questions please call, fax or email: Phone/FAX: (604) 921-8730 Email: nsaikido@telus.net For Lower Lonsdale Residents Only: No grant is required Full Scholarship Sliding Scale Tuition Barter for Tuition Child's Age as of July 08: 6 years old 7 years old 8 years old 9 years old 10 years old 11 years old 12 years old Child's First Name: * Child's Last Name: * Parent's First Name: * Parent's Last Name: * Parent's Email Address: * Address: * City: * Province: Postal Code: Parent's Phone Number: * Previous Martial Arts Background: Sibling Discount of 20% for payments made anytime: (Hold down shift or option key for multiple selections) Budo Summer Camp $250 Budo Camp Sibling $200 Parent/Guardian Authorization* * *Required Information *Please read the Waiver and Release of Liability (below), then authorize as acknowledgement.

North Vancouver Aikikai WAIVER AND RELEASE OF LIABILITY By signing this form you give up important legal rights. Please read carefully! This is a binding legal agreement. As a Participant in the programs, activities and events of North Vancouver Aikikai, the undersigned acknowledges and agrees to the following terms. Disclaimer North Vancouver Aikikai and/or the United States Aikido Federation, its directors, officers, members, employees, independent contractors, instructors, coaches, volunteers, officials, participants, clubs, agents, sponsors, funding partners, owners/operators of the facility, and representatives (the “Organization”) are not responsible for any injury, damage or loss of any kind suffered by a Participant during, or as a result of, any program, activity or event, caused in any manner whatsoever including, but not limited to, the negligence of the Organization. Description of Risks In consideration of my participation in such programs, activities and events, I hereby acknowledge that I am aware of the risks and hazards associated with or related to the sport of Aikido and that they may result in personal injury, death, property damage, expense and related loss to me. I understand that Aikido training is practiced without protective clothing or equipment and involves many inherent physical risks. These include, but are not limited to, injuries resulting from: • Ongoing physical contact with the instructor and other students; • Striking objects with parts of the body; • Executing strenuous and demanding physical techniques; • Collisions with the wall, floor, other students and instructors; • Extreme changes in temperature; • Tumbling, falling or being thrown to the floor; • Strenuous cardiovascular workouts; • Exerting and stretching various muscle groups; • Executing self-defence escapes and techniques; • Dehydration; • Travel to and from associated non-competitive events which are an integral part of the organization’s activities. Furthermore, I am aware: • That injuries sustained in Aikido can be severe; • That I may come into close contact with other participants, including the possibility of accidental and unexpected touching; • That I may experience anxiety while challenging myself during the activities; • That my risk of injury is reduced if I follow all rules adopted during training and competition; and • That my risk of injury increases as I become fatigued. Release of Liability In consideration of the Organization allowing me to participate, I agree: a) To assume all risks arising out of, associated with or related to my participation; b) To be solely responsible for any injury, loss or damage that I might sustain while participating; and c) To release the Organization from liability for any and all claims, demands, actions and costs that might arise out of my participating, even though such risks, injuries, loss, damage, claims, demands, actions or costs may have been caused by the negligence of the Organization. Acknowledgement I have read this agreement, that I have executed this agreement voluntarily, and that this agreement is to be binding upon myself, my heirs, executors, administrators and representatives.