ASJJ Annual Member Subscription

To be completed by (or if under 18-yrs in the name of) the member

In completing this form, if you need to gather more information you can save and resume later.

A copy of this form will be forwarded to the Senior Dojo Sensei you nominate below.

Members Details

[*] Only Select YES if since you completed your application for membership OR since last updating your details within a member subscription?

Branch Dojo and Grade

Martial Arts History

[*] Only Select YES if since you completed your application for membership OR since last updating your details within a member subscription?

Related Health Declaration

[*] Only Select YES if since you completed your application for membership OR since last updating your details within a member subscription? ... If you select YES you can review the questions and if unchanged you can then select NO

First Aid and Indemnity

Liability Waiver - It has been explained to me and I understand that training, practicing, or participating in martial art is dangerous and that I must at all times abide by the rules of Australian Society of Ju-Jitsuans (ASJJ) and any instruction provided to me by Australian Society of Ju-Jitsuans and those instructing me in Jujutsu and obtain clarification before proceeding if those rules or that instruction are not understood.

Further I understand and agree that my participation is entirely at my own risk. I and any other person in relation to myself hereby absolves, indemnifies and holds harmless the providers, including others receiving instruction from all liability howsoever arising for injury, loss or damage (including but not limited to my person, property and personal belongings) however caused, including by the negligence of the indemnified, arising out of or in connection with the provision of instruction or related services or in any way caused by, or arising out of any activity carried on by the providers.

Preferred Payment Method

Signature

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