We need this Activity Waiver to complete your Camp or Event order.

If you registered for martial arts classes, please follow this link to the class waiver form:

https://www.ohanamartialarts.org/forms

Clinics, Camps and other Activity Registrations - complete 1 waiver below for each camper every calendar year. Update if medical or contact information has changed. Mahalo!

We reserve the right to cancel and refund any and all class/lesson/clinic/camp registrations that come in without a waiver. You only need to complete 1 waiver each calendar year - not every time you sign up. Our firmness is due to having to spend too much time tracking down parents to create our emergency contact list in a timely fashion. Thank you for understanding! (please note this form is separate and different from martial arts class waiver forms)

Student Name

Please complete and sign this form prior to participating 2024 camp or drop off programming at ‘Ohana Martial Arts. Completed forms must be submitted online.

First Name

Last Name

Student Age

Parent/Gaurdian(s) Names

Primary Phone Number for Emergency

(###)

###

####

Secondary Phone Number for Emergency

(###)

###

####

Other Emergency contact

(###)

###

####

• Does the participating student have any medical conditions we should know about? (none if not)

• Are there any other allergies or special circumstances that need our attention? (none if not)

Email Address (all camp information about the camp you signed up for will be emailed by the Friday before your camp - if you feel you are missing information try searching your email for ohanaselfdefense@gmail.com)

Would you like to receive emails about future dojo happenings?

Yes

I already get emails

Permission to use images of your student 'Ohana Martial Arts is authorized by to use video or photographs of your student for advertising, publicity and public relations. Video-footage will only be used by 'Ohana Martial Arts Non-profit Self-defense School. No further claims may be made. If there is a court ordered safety issue with use of photos/videos such as foster children please let us know in advance.

Agree

Agree, but for exceptional reasons please try to remove pictures of my child from advertising, publicity and public relations. (We will try our best, but please know it is not illegal to use pictures from public settings of large groups at camp).

Emergency Care By checking this box I agree that if 'Ohana Martial Arts Non-Profit Self-Defense School are unable to contact the emergency contact on file and 'Ohana Martial Arts supervisor on duty determines your student is ill or injured and needs emergency care - emergency medical staff will be called. If medical staff determines camper needs treatment it will be provided and billed to campers family.

Agree

Full Responsibility Waiver I, _____________________________, take sole responsibility for any personal injury I (or my participating family members) may incur over the course of any and all 'Ohana Martial Arts Non-Profit Self-Defense School programs we may participate in. I acknowledge that participation in this program exposes me to potential risks and I release all instructors or fitness coaches from any and all liabilities regarding an injury and will cover all medical costs associated with injuries from participation. I shall not now or in the future prosecute any lawsuit against 'Ohana Martial Arts non-profit self-defense school or its directors, board of directors or instructors. I’m aware that this agreement will be legally binding. I have read and understood this Injury Waiver and Medical Release Form as a participant or a parent/guardian.

Agree

Discipline: Appropriate firm but kind discipline is used to insure safety for all staff and students. All children are expected to respect themselves, others and all property. Sitting out from activities will be enforced if a student is acting in an unsafe manner. If persistent or severe behavior problems are interrupting programing or endangering students or staff, parents/guardians will be contacted to remove their student from the program immediately. We realize our program is not for everyone, please use your discernment as to if this type of active, busy, potentially loud outdoor program is best for your child. They need to be able to safely operate in an up to 10:1 ratio for campers under 6 and up to 20:1 staff to camper ratio for 8 and older. 'Ohana Martial Arts Non-profit Self-Defense School reserves the right to refuse any student from future programming. I give 'Ohana Martial Arts Non-profit Self-Defense School the authority to exercise these discipline policies in regard to my camper or student and will be available should my student be persistently disrespectful or unsafe.

Agree

I understand that there are risks in attending camp and me or my family may be inadvertently exposed to illness, including COVID. ‘Ohana Martial Arts follows all laws and regulations and should Kona have widespread community spread of any illness or virus, this camp may close for the protection of the participants and community. I release 'Ohana Martial Arts, all instructors or fitness coaches from any and all liabilities regarding illness, closures and will cover all medical costs associated with illness from participation. I shall not now or in the future prosecute any lawsuit against 'Ohana Martial Arts non-profit self-defense school or its directors, board of directors or instructors. Campers and staff with active cold symptoms are not allowed at camp. We will safely isolate campers with new symptoms until you come to pick them up. Parents or gardians are expected to be available or have an appointed adult able to come pick up sick campers.

Agree

Participant Signature or Participants Parents/Guardians Signature if student is under 18 I Sign and Agree to all terms of this form and waiver. I understand the medical information on this form will be used only by health officials and EMT’s in case of a medical emergency. I understand 'Ohana Martial Arts Non-Profit Self-Defense School is an equal opportunity organization and does not deny enrollment or discriminate based on race, color, religion, gender or national origin. I understand it is my responsibility to update this information if changes occur to my or my child's health. I understand that by typing my full name where indicated below, I consent to the use of electronic records and signatures in the manner described above, and the electronic storage of such documents. Typing my name below constitutes a legal signature and confirms I am the legal guardian of the above named camper.

We need this Activity Waiver to complete your Camp or Event order.

Clinics, Camps and other Activity Registrations - complete 1 waiver below for each camper every calendar year. Update if medical or contact information has changed. Mahalo!

Location: PO Box 1805 Kailua-Kona HI 96740

Phone: (808)494-2346

Email: ohanaselfdefense at gmail dot com

Images and Website by Tara Brown all rights reserved