The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization.  COVID-19 is extremely contagious and is believed to spread mainly fromperson-to-person contact and from contact with surfaces which have the virus on them. As a result,federal, state, and local governments and health agencies have recommended various means of avoiding infection and preventing spread of COVID-19.


American Karate Studio’s has attempted to comply with and is continuing to attempt to comply

with the recommendations from state and federal agencies referred to above. However, as long as

COVID-19 is active in society, none of those means are guaranteed to prevent spread of COVID-19

or to allow any individual to avoid infection.


By signing this document, the undersigned Student (or parent on behalf of Student if Student is a

minor) hereby acknowledges the contagious nature of COVID-19 and voluntarily assumes the risk

that Student may be infected by and/or exposed to COVID-19 by attending classes/instruction at

American Karate Studio’s.


By signing this Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19,

Student also acknowledges that such exposure or infection may result in personal injury, illness,

permanent disability, and death to anyone exposed to or infected by COVID-19, including Student

if Student becomes exposed to and/or infected by COVID-19. Student understands that the risk of

becoming exposed to or infected byCOVID-19 at American Karate Studio’s may result from the

actions, omissions, or negligence of various persons or things, including, but not limited to,

employees of American Karate Studio’s, other students of American Karate Studio’s, the

families/friends of those students who may be present at classes, and even the American Karate Studio's,

and due to fomites potentially present on the physical surfaces in the dojo.


To the fullest extent permitted by applicable law, Student voluntarily agrees to assume all of the

foregoing risks and accept sole responsibility for any injury to Student, including, but not limited to,

personal injury, disability, and death, illness, damage, loss, claim, liability, or expense, of any kind,

that Student may experience or incur in connection with attending classes/instruction at American Karate Studios

Student hereby releases, covenants not to sue, discharges, and holds harmless American Karate Studio's, its employees, agents, and representatives, in their personal, professional, or company

capacities, of and from the Claims, including all liabilities, claims, actions, damages, costs or

expenses of any kind arising out of or relating thereto.




Name of Student:    ___________________________

Student DOB:_____________________________

Class Enrolled in: ____________________





This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. 


Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.


Name of parent/guardian: ______________________