Sri Guru Hargobind Patsahi 6 Gatka Akhara Registration Form by chenboying


									               Sri Guru Hargobind Patsahi 6 Gatka Akhara Registration Form – Under 18

As the parent/guardian, I give my child(s)

(Child’s full name)                                                aged:_____ full consent to become a student of the
Akhara. In doing so, I agree to the following:

1. In case of a medical emergency, I grant the Akhara the right to authorize medical care (i.e. contacting a hospital or
emergency services) if none of the persons named below can be reached.

To contact in case of emergency:
Next of Kin:                                     Relationship:                 ___
Home Tel:                             _   _ __ Work Tel:                     ___                 _
Family Physician/Doctor:                                                        ____ __
Indicate any special medical conditions you have:
(i.e. diabetes, asthma):

2. My child(s) has no serious health problems that could affect him/her or others around them while training

3. I understand that the Akhara or Gurdwara volunteers cannot be held responsible for death or injury to my child(s)

4. I do not hold Akhara responsible for damage or loss of my child(s) property. Furthermore, I assume full responsibility for
any damage to persons or property caused by child(s)

5. I will ensure that my child(s) does not teach what he/she learns in training to others outside the Akhara

6. I will ensure that my child(s) does not use what they learn to intimidate or harm others

7. I will ensure that my child(s) respects all female Akhara members as a sister and male members as a brother.
(Relationships other than these will not be tolerated)

8. I accept that the Akhara cannot be held responsible if my child(s) is subject to foul, explicit or offensive language.
Furthermore, I assume full responsibility if my child uses similar language or actions.

9. I accept the responsibility of bringing my Child(s) to and from training or other events that the Akhara may be attending.
Furthermore, I understand that the Akhara on rare occasions may offer help with transport without accepting any
responsibility of my child(s) as stated in the conditions of this registration agreement.

10. I understand that the Akhara is run on a voluntary basis. (A donation of £2 a month can be made voluntarily to help
with administration and maintenance costs)

11. I understand that the Akhara has the right to terminate student membership at any time without prior notice.

12. I understand that the Akhara will occasionally send my child(s) training related messages via email or SMS

(Please provide your Email: __________________________________ Mobile No: __________________________

Martial art training is a potentially dangerous activity. Before beginning any martial arts training or exercise program, you
should first consult your physician. Bumps, bruises, scrapes, scratches and soreness are commonplace, and most students
will encounter this sort of minor injury from time to time in their training. More serious injuries are possible, including sprains,
strains, twists, cramps, and injuries of similar magnitude, and students can expect to encounter these injuries infrequently.
The possibility of more serious injury exists, including fractured bones, broken bones, and torn ligaments, though not all
students encounter such serious injuries. As with any physical activity, there also exists the remote possibility of crippling or

By signing this document, you are affirming that you understand all the above statement(s) of risk, and accept the
responsibility for any training techniques, advice, and/or methodologies used in training. You assume responsibility for your
child(s) safety, understanding and accepting all risks involved with martial arts training. By assuming this risk, you
completely absolve all authors, creators, trainers and affiliates of the Akhara from liability.

(Signature of Parent or Guardian)                                _____          (Date)


To top