I understand and agree that strict observation of Bansenshukai Dojo rules and regulations and the rules and regulations relative to the service or instruction provided, including the use of protective equipment, is required. I understand and agree that use of Bansenshukai Dojo facilities and my presence at said facility are at the sole risk of myself. I understand and agree that the services or instruction provided may involve skills and training which include violent and sudden movements and that in connection with the training and instruction, there may be physical contact between instructors and members, including myself, and between and among the members, including myself, and that such contact may result in personal injury to myself, despite precautions taken to avoid such injuries.  I hereby consent to engage in such contact as may be necessary or required by my participation.

Checking below constitutes acceptance of this release and acts as my Electronic Signature.