July 17, 2016 Aldo Sunaryo Registration First & Last Name* (Parent's if applicant is under 18 years of age) DOB GenderMF Child's Name DOB GenderMF Child's Name DOB GenderMF Child's Name DOB GenderMF Child's Name DOB GenderMF Child's Name DOB GenderMF Address City State Zip Email* Phone Mobile Phone* Registration Fee: $50.00 Individual, $100.00 Family Karate Uniform: $65.00 and up Agreement Terms Katy Dojo LLC offers contract agreements with various terms and discounts. One month - Month-to-month, no committed contract 3 Month 6 Month One Year For details on fees and contracts, please contact us by phone or email 12 Months Contract Pay the monthly fees with ACH collection for Karate-Do Shotokan training. Includes a Free Karate Uniform & Free T-shirt & Free registration fees. (A checking or savings accounts needed.) 6 Months Paid in Full Deal Pay for half year of Karate-Do Shotokan in advance, and get a Free Karate Uniform & Free T-shirt & Free registration fees. (Cash or check / ACH collection) Contract Discounts We offer discount on the monthly fees for contracts ranging from 3 months, 6 months to one year. Preferred Schedule It is recommended to attend at least 2 classes per week in the appropriate age group Classes in green are 30 minutes beginners classes orange are 1 hour beginners classes blue are 1 hour intermediate classes black are advanced classes *Friday 6:00PM class is open for all levels Mon Tue Wed Thu Fri Sat Tigers(Age 4-6) 5:00PM5:30PM 5:00PM5:00PM 5:00PM5:30PM 5:00PM5:00PM7:00PM 5:00PM5:30PM 9:30AM11:00AM11:00AM4:00PM Kids(Age 7-9) 5:00PM5:30PM6:00PM 5:00PM5:30PM6:00PM 5:00PM5:30PM6:00PM 6:00PM7:00PM7:30PM 5:00PM5:30PM6:00PM 9:30AM11:00AM11:00AM4:00PM Youths(Age 10-13) 5:30PM6:00PM7:00PM8:00PM 6:00PM 5:30PM6:00PM7:00PM8:00PM 6:00PM7:00PM7:30PM 5:30PM6:00PM 9:30AM10:00AM Kata/Kumite11:00AM12:00AM4:00PM Teen & Adults(Age 14 & up) 5:30PM6:00PM7:00PM8:00PM 6:00PM 5:30PM6:00PM7:00PM8:00PM 6:00PM7:30PM8:00PM 5:30PM6:00PM 9:30AM10:00AM Kata/Kumite11:00AM12:00AM4:00PM Waiver KATY DOJO LLC RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT In consideration for your being permitted to enter, observe, use or participate in the premises, facilities, equipment, and affiliated programs, Without respect to location, of the Katy Dojo LLC for any purpose, you agree to the following: You, on behalf of yourself, your personal representatives, heirs and next of kin (“You”), warrant that you have inspected and considered, or immediately upon entering will inspect and consider the Katy Dojo LLC Facilities, and you accept the Facilities as being safe and reasonably suited for your entry, observation, use, or participation. YOU HEREBY RELEASE, WAIVE, AND COVENANT NOT TO SUE FOR, AND YOU SHALL INDEIVINIFY, DEFEND AND HOLD HARMLESS THE Katy Dojo LLC ITS AFFILIATES, BRANCHES, DIRECTORS, OFFICERS, EMPLOYEES, VOLUNTEERS, AND AGENTS (COLLECTIVELY, FROM AND AGAINST ANY ECONOMIC OR NON-ECONOMIC LOSSES, LIABILITIES/ DAMAGES,SUITS, ACTIONS, CLAIMS, ATTORNEY’S FEES, COSTS, EXPENSES, OR DEMANDS,RELATING IN ANY WAY TO BODILY INJURY, DEATH, OR PROPERTY DAMAGE SUSTAINED BY YOU AND/OR YOUR MINOR CHILD OR LEGAL WARD WHILE PRESENT IN, OBSERVING, USING, OR PARTICIPATING IN THE Katy Dojo LLC FACILITIES, OR ARISING OUT OF OR IN ANY WAY CONNECTED TO YOUR OR YOUR MINOR OR LEGAL WARD’S PRESENCE IN, OBSERVATION OF, USE OF, OR PARTICIPATION IN THE KATY DOJO LLC FACILITIES, WHETHER CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE, GROSS NEGLIGENCE OR STRICT LIABILITY OF THE KATY DOJO LLC, OR OTHERWISE, TO THE FULLEST EXTENT PERMITTED BY LAW. YOU VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISK OF BODILY INJURY, DEATH, OR PROPERTY DAMAGE WHILE YOU OR YOUR MINOR CHILD OR LEGAL WARD ARE PRESENT IN, OBSERVING, USING OR PARTICIPATING IN THE Katy Dojo LLC FACILITIES, OR ARISING OUT OF OR IN ANY WAY CONNECTED TO YOUR OR YOUR MINOR CHIILD’S OR LEGAL WARD’S PRESENCE IN, OBSERVATION OF, USE OF OR PARTICIPATION IN THE Katy Dojo LLC FACILITIES, WHETHER CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE, GROSS NEGLIGENCE OR STRICT LIABILITY OF THE KATY DOJO LLC OR OTHERWISE, TO THE FULLEST EXTENT PERMITTED BY LAW. You assume full responsibility for any items lost or stolen while you are present in, observing, using or participating in the Katy Dojo LLC Facilities. You give permission to the Katy Dojo LLC to use photographs, film footage, or tape recordings which may include your own image or voice (or that of your minor child or legal Ward) for purposes of promoting Katy Dojo LLC Facilities. You agree to abide by all rules promulgated by the Katy Dojo LLC While You or Your minor child or legal Ward are present in, observing, using, or participating in any Katy Dojo LLC Facilities. You further expressly agree that this RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT cannot be altered in any Way, and is intended to be as broad and inclusive as is permitted by Texas law, and that if any portion of this RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT is held invalid, you agree that the balance shall, not with standing, continue in full legal force and effect. You have read and voluntarily sign this RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT and agree that no oral representations, statements, or inducement apart from this written agreement have been made to you. Check here if you accept the terms stated in the waiver.