Please up this online form to register for membership. For payment, we only accept credit card or ACH mode of payment. Payment needs to be arranged at Seiei Dojo in person.

MEMBERSHIP REGISTRATION FORM

Name *
Name
Phone
Phone
Address *
Address
Birthday *
Birthday
Program *
1st Additional Family Member Name
1st Additional Family Member Name
2nd Additional Family Member Name
2nd Additional Family Member Name
This Terms and Agreement constitute the entire and exclusive membership agreement between the parties. Any promise, representation, understanding, oral or written, pertaining directly or indirectly to the agreement which are not continued herein, are hereby waived. LIABILITY AND WAIVER OF LIABILITY I understand that I will be required to comply with the Seiei Dojo Rules and Bylaws Knowing the risks involved in the martial art\sport of Judo\Muay Thai\Boxing\Yoga, I assume all such risks and accept personal responsibility for the damages following such injury, illness, disease, permanent disability, or death. I hereby release, waive, discharge and covenant not to sue the United States Judo Federation, Inc.,USA Judo/United States Judo, Inc., United States Judo Association, Inc., Northwest Judo Yudanshakai, Inc. , and the Seiei Dojo, together with their affiliated clubs, their respective administrators, directors, officers, agents, coaches, instructors and other employees or volunteers of the organization, event officials, medical personnel, other participants, their parents, legal guardians, supervisors and coaches, sponsoring agencies, sponsors, advertisers, and if applicable, owners, lessors, and lessees of premises used in conducting the event, all of whom are hereinafter referred to as "Releases", from any and all litigation expenses, attorney fees, loss, liability, damage or costs on account of injury, illness, disease, including permanent disability and death or damage to property, caused or alleged to be caused in whole or in part by the negligent acts or omissions of the Releases or otherwise to the fullest extent permitted by law. I acknowledge and fully understand that I will be engaging in physical activities that might result in serious injury, illness or disease, including permanent disability or death, and severe social and economic losses due not only to my own actions, inactions or negligence, but also to the actions, inactions, or negligence of others or conditions of the premises or of any equipment used. Further, I acknowledge that there may be other risks not known to me or not reasonably foreseeable at this time. I understand that I will be required to obtain a United States Judo Federation membership (for judo students) to ensure I have adequate personal and public liability insurance, and to renew it when necessary if I wish to continue practicing at Seiei Dojo. I, the applicant, state that I am 18 years of age or over. In consideration of being permitted to participate in any way, I acknowledge and agree to release, waive, and discharge , to the extent permitted by law, Seiei Dojo from or for all claims, demands and causes of actions or any other liabilities that may arise or be caused in whole or in part by the negligence of Seiei Dojo , in conjunction with or arising out of involved in Judo\Muay Thai\Boxing\Yoga, and do hereby assume these risks and accept the responsibility for any damages or injuries by engaging in Judo\Muay Thai\Boxing\Yoga. PARENTAL INDEMNIFICATION (For Judo members only) I state that I am the parent/legal guardian of the applicant, a minor. I agree to indemnify and hold harmless the Seiei Dojo for any expenses incurred, claims made or liabilities assessed against them as a result of injury, death, or insufficiency of any legal capacity. I consent to the applicant’s becoming a member of Seiei Dojo & participating in training, practices, clinics, & events, sanctioned or sponsored by Seiei Dojo, USJF, USJA or USA Judo. 1. I MUST PAY THE TOTAL DUE TODAY UPON SIGNING THIS AGREEMENT. 2. SUSPENSION/TERMINATION OF MEMBERSHIP BY MANAGEMENT. Management has the right to suspend and/or terminate any membership for non-payment of dues, fees, Seiei Dojo Property dues, or for behavior inimical to the enjoyment of the Seiei Dojo by other members and staff for any reason deemed sufficient in the sole discretion of Management. 3. Members have the right to cancel this contract within three (3) business days after receipt of a copy of this contract. Cancellation must be in writing and delivered to the Seiei Dojo either in person, or by email. Members may voluntarily terminate membership at any time for any reason by: 1) notifying the the Seiei Dojo in writing, return receipt requested or in person 30 days prior to cancellation and; 2) paying all current charges prior to termination the Seiei Dojo Enrollment Fees are non-refundable. 4. Membership can be terminated for any violation of Seiei Dojo Code of Conduct. 5. United Stated Judo Federation annual membership is required for all Judo members. I HAVE READ THE ABOVE TERMS AND AGREEMENT, WAIVER, AND RELEASE, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND KNOWING THIS, SIGN IT VOLUNTARILY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE. I AGREE TO PARTICIPATE KNOWING THE RISKS AND CONDITIONS INVOLVED AND DO SO ENTIRELY OF MY OWN FREE WILL. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENT/LEGAL GUARDIAN AS EVIDENCED BY THEIR SIGNATURE BELOW. I INTEND THIS TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THAT THE BALANCE, NOTWITHSTANDING SHALL CONTINUE IN FULL FORCE AND EFFECT. BY ENTERING YOUR NAME BELOW AND CLICKING THE SUBMIT BUTTON, YOU ARE PROVIDING AN ELECTRONIC SIGNATURE AND STATE THAT YOU HAVE READ AND AGREE WITH TERMS AND AGREEMENT ABOVE.