MyKarateClub

REGISTER (STEP 1 OF 6)

Complete these to start. If already registered for 2025 we’ll let you know.

Student First Name *

Student Last Name *

Birthdate (MM/DD/YYYY) *

Gender *

DETAILS (STEP 2 OF 6)

Fill in the rest of your information.

Address *

City *

Province *

Postal Code *

Cell Number *

Email Address

Emergency Contact Details *

Alternate Cell Number

Alternate Email Address

Alternate Contact Details

Relevant Medical Conditions (Please Specify)

SHINTANI WADO KAI KARATE FEDERATION (STEP 3 OF 6)
PERSONAL INFORMATION PROTECTION AND ELECTRONIC DOCUMENTS ACT (PIPEDA) RELEASE AND AGREEMENT

YOU MUST SELECT THE CHECKBOX TO CONTINUE.

The personal information you provide to your Karate club is collected under the authority of the PIPEDA privacy bill for Canada. It is used to determine your eligibility for competitive and recreational opportunities, age-related events, for class placement, to facilitate your enrolment, to administer and evaluate programs/courses of benefit to athletes, instructors, Federation Members, volunteers, judges and referees, and for insurance and statistical purposes. In addition, personal information may be, from time to time, submitted to major funding bodies in order to verify registration and meet the funding requirements.
Member clubs of the SWKKF collect information from their members when they register to take part in a karate program. Registration information required by the SWKKF may include: name, age, birth date, address, phone number, gender, rank, emergency contact information, and provincial medical number in case of accident or illness.
Your club’s Privacy Officer, as well as the Privacy Officer for the SWKKF, are responsible for your personal information, and the personal information concerning any minor children, and they ensure that all personal information is handled in a confidential manner, and all reasonable precautions are taken to avoid loss, theft, or unauthorized access, disclosure, copying, use, or modification.

BY CHECKING THIS BOX, YOU ARE INDICATING THAT RECORDING AND TRANSMISSION OF PERSONAL INFORMATION FROM THE KARATE CLUB TO THE SWKKF PRIVACY OFFICER IS PERMISSIBLE

PHOTOS (STEP 4 OF 6)

YOU MUST SELECT YES OR NO TO CONTINUE.

Do you give permission for photographs of the participant to be used as described above?

YES — I GIVE PERMISSION

NO — I DO NOT GIVE PERMISSION

INFORMED CONSENT AND ASSUMPTION OF RISK AGREEMENT (STEP 5 OF 6)

YOU MUST SELECT THE 3 CHECKBOXES TO CONTINUE.

WARNING! BY ACKNOWLEDGING THIS DOCUMENT, YOU WILL ASSUME CERTAIN RISKS AND RESPONSIBILITIES. PLEASE READ CAREFULLY

THIS IS A BINDING LEGAL AGREEMENT. CLARIFY ANY QUESTIONS OR CONCERNS BEFORE SIGNING. AS A PARTICIPANT IN THE SPORT OF KARATE AND THE ORIENTATION, INSTRUCTION, ACTIVITIES, PROGRAMS, AND SERVICES OF KARATE (COLLECTIVELY THE “ACTIVITIES”), THE UNDERSIGNED, BEING THE PARTICIPANT AND THE PARTICIPANT’S PARENT/GUARDIAN (COLLECTIVELY THE “PARTIES”), ACKNOWLEDGE AND AGREE TO THE TERMS OUTLINED IN THIS DOCUMENT.
DISCLAIMER
THE KARATE CLUB, ITS DIRECTORS, OFFICERS, COMMITTEE MEMBERS, MEMBERS, EMPLOYEES, COACHES, VOLUNTEERS, OFFICIALS, PARTICIPANTS, AGENTS, SPONSORS, OWNERS/OPERATORS OF THE FACILITIES IN WHICH THE ACTIVITIES TAKE PLACE, AND REPRESENTATIVES (COLLECTIVELY THE “THE ORGANIZATION”) ARE NOT RESPONSIBLE FOR ANY INJURY, PERSONAL INJURY, DAMAGE, PROPERTY DAMAGE, EXPENSE, LOSS OF INCOME OR LOSS OF ANY KIND SUFFERED BY THE PARTICIPANT DURING, OR AS A RESULT OF, THE ACTIVITIES, CAUSED IN ANY MANNER WHATSOEVER INCLUDING, BUT NOT LIMITED TO, THE NEGLIGENCE OF THE ORGANIZATION.

I HAVE READ AND AGREE TO BE BOUND BY PARAGRAPHS 1 AND 2

DESCRIPTION OF RISKS
THE PARTIES UNDERSTAND AND ACKNOWLEDGE THAT:
1. THE ACTIVITIES HAVE FORESEEABLE AND UNFORESEEABLE INHERENT RISKS, HAZARDS AND DANGERS THAT NO AMOUNT OF CARE, CAUTION OR EXPERTISE CAN ELIMINATE, INCLUDING WITHOUT LIMITATION, THE POTENTIAL FOR SERIOUS BODILY INJURY, PERMANENT DISABILITY, PARALYSIS AND LOSS OF LIFE.
2. THE ORGANIZATION MAY OFFER OR PROMOTE ONLINE PROGRAMMING (SUCH AS WEBINARS, REMOTE CONFERENCES, WORKSHOPS, AND ONLINE TRAINING) WHICH HAVE DIFFERENT FORESEEABLE AND UNFORESEEABLE RISKS THAN IN-PERSON PROGRAMMING.
3. THE ORGANIZATION HAS A DIFFICULT TASK TO ENSURE SAFETY AND IT IS NOT INFALLIBLE. THE ORGANIZATION MAY BE UNAWARE OF THE PARTICIPANT’S FITNESS OR ABILITIES, MAY GIVE INCOMPLETE WARNINGS OR INSTRUCTIONS, MAY MISJUDGE WEATHER OR ENVIRONMENTAL CONDITIONS, AND THE EQUIPMENT BEING USED MIGHT MALFUNCTION.
4. THE NOVEL CORONAVIRUS, COVID-19, HAS BEEN DECLARED A WORLDWIDE PANDEMIC BY THE WORLD HEALTH ORGANIZATION AND COVID-19 IS EXTREMELY CONTAGIOUS. THE ORGANIZATION HAS PUT IN PLACE PREVENTATIVE MEASURES TO REDUCE THE SPREAD OF COVID-19; HOWEVER, THE ORGANIZATION CANNOT GUARANTEE THAT THE PARTICIPANT WILL NOT BECOME INFECTED WITH COVID-19. FURTHER, ATTENDING THE ACTIVITIES COULD INCREASE YOUR RISK OF CONTRACTING COVID-19.
THE PARTICIPANT IS PARTICIPATING VOLUNTARILY IN THE ACTIVITIES. IN CONSIDERATION OF THAT PARTICIPATION, THE PARTIES HEREBY ACKNOWLEDGE THAT THEY ARE AWARE OF THE RISKS, DANGERS AND HAZARDS AND MAY BE EXPOSED TO SUCH RISKS, DANGERS AND HAZARDS. THE RISKS, DANGERS AND HAZARDS INCLUDE, BUT ARE NOT LIMITED TO:
1. CONTRACTING COVID-19 OR ANY OTHER CONTAGIOUS DISEASE.
2. PRIVACY BREACHES, HACKING, TECHNOLOGY MALFUNCTION OR DAMAGE.
3. EXECUTING STRENUOUS AND DEMANDING PHYSICAL TECHNIQUES.
4. VIGOROUS PHYSICAL EXERTION, STRENUOUS CARDIOVASCULAR WORKOUTS AND RAPID MOVEMENTS.
5. EXERTING AND STRETCHING VARIOUS MUSCLE GROUPS.
6. THE FAILURE TO PROPERLY USE ANY PIECE OF EQUIPMENT OR FROM THE MECHANICAL FAILURE OF ANY PIECE OF EQUIPMENT.
7. SPINAL CORD INJURIES WHICH MAY RENDER ME PERMANENTLY PARALYZED.
8. STRIKING PARTICIPANTS AND OBJECTS WITH PARTS OF THE BODY.
9. CONTACT, COLLIDING OR BEING STRUCK BY OTHER PARTICIPANTS.
10. TUMBLING, FALLING OR BEING THROWN TO THE FLOOR.
11. SERIOUS INJURY TO VIRTUALLY ALL BONES, JOINTS, LIGAMENTS, MUSCLES, TENDONS AND OTHER ASPECTS OF MY BODY OR TO MY GENERAL HEALTH AND WELL-BEING.
12. ABRASIONS, SPRAINS, STRAINS, FRACTURES, OR DISLOCATIONS.
13. CONCUSSION OR OTHER HEAD INJURIES, INCLUDING BUT NOT LIMITED TO, CLOSED HEAD INJURY OR BLUNT HEAD TRAUMA.
14. PHYSICAL CONTACT WITH OTHER PARTICIPANTS, SPECTATORS, EQUIPMENT, AND HAZARDS.
15. NOT WEARING APPROPRIATE SAFETY OR PROTECTIVE EQUIPMENT.
16. FAILURE TO ACT SAFELY OR WITHIN MY OWN ABILITY OR WITHIN DESIGNATED AREAS.
17. NEGLIGENCE OF OTHER PERSONS, INCLUDING OTHER SPECTATORS OR PARTICIPANTS.
18. WEATHER CONDITIONS.
19. TRAVEL TO AND FROM COMPETITIVE EVENTS AND ASSOCIATED NON-COMPETITIVE EVENTS WHICH ARE AN INTEGRAL PART OF THE ACTIVITIES.

I HAVE READ AND AGREE TO BE BOUND BY PARAGRAPHS 3 AND 4

TERMS
IN CONSIDERATION OF THE ORGANIZATION ALLOWING THE PARTICIPANT TO PARTICIPATE IN THE ACTIVITIES, THE PARTIES AGREE:
1. THAT THE PARTICIPANT’S MENTAL AND PHYSICAL CONDITION IS APPROPRIATE TO PARTICIPATE IN THE ACTIVITIES.
2. THAT WHEN THE PARTICIPANT PRACTICES OR TRAINS IN HIS OR HER OWN SPACE, THE PARTIES ARE RESPONSIBLE FOR THE PARTICIPANT’S SURROUNDINGS AND THE LOCATION AND EQUIPMENT THAT IS SELECTED FOR THE PARTICIPANT.
3. TO COMPLY WITH THE RULES AND REGULATIONS FOR PARTICIPATION IN THE ACTIVITIES.
4. TO COMPLY WITH THE RULES OF THE FACILITY OR EQUIPMENT.
5. THAT IF THE PARTICIPANT OBSERVES AN UNUSUAL SIGNIFICANT HAZARD OR RISK, THE PARTICIPANT WILL REMOVE THEMSELVES FROM PARTICIPATION AND BRING SUCH TO THE ATTENTION OF AN ORGANIZATION REPRESENTATIVE IMMEDIATELY.
6. THE RISKS ASSOCIATED WITH THE ACTIVITIES ARE INCREASED WHEN THE PARTICIPANT IS IMPAIRED, AND THE PARTICIPANT AGREES NOT TO PARTICIPATE IF IMPAIRED IN ANY WAY.
7. THAT IT IS THEIR SOLE RESPONSIBILITY TO ASSESS WHETHER ANY ACTIVITIES ARE TOO DIFFICULT FOR THE PARTICIPANT. BY THE PARTICIPANT COMMENCING AN ACTIVITY, THEY ACKNOWLEDGE AND ACCEPT THE SUITABILITY AND CONDITIONS OF THE ACTIVITY.
8. THAT THEY ARE RESPONSIBLE FOR THE CHOICE OF THE PARTICIPANT’S PROTECTIVE EQUIPMENT AND THE SECURE FITTING OF THE PROTECTIVE EQUIPMENT.
9. THAT COVID-19 IS CONTAGIOUS IN NATURE AND THE PARTICIPANT MAY BE EXPOSED TO OR INFECTED BY COVID-19 AND SUCH EXPOSURE MAY RESULT IN PERSONAL INJURY, ILLNESS, PERMANENT DISABILITY OR DEATH AND VOLUNTARILY AGREE TO ASSUME ALL OF THE FOREGOING RISKS.
IN CONSIDERATION OF THE ORGANIZATION ALLOWING THE PARTICIPANT TO PARTICIPATE, THE PARTIES AGREE:
1. THAT THE PARTIES ARE NOT RELYING ON ANY ORAL OR WRITTEN STATEMENTS MADE BY THE ORGANIZATION OR THEIR AGENTS, WHETHER IN BROCHURE OR ADVERTISEMENT OR IN INDIVIDUAL CONVERSATIONS, TO AGREE TO BE INVOLVED IN THE ACTIVITIES.
2. THAT THE ORGANIZATION IS NOT RESPONSIBLE OR LIABLE FOR ANY DAMAGE TO THE PARTICIPANT’S VEHICLE, PROPERTY, OR EQUIPMENT THAT MAY OCCUR AS A RESULT OF THE ACTIVITIES.
THE PARTIES AGREE THAT IN THE EVENT THAT THEY FILE A LAWSUIT AGAINST THE ORGANIZATION, THEY AGREE TO DO SO SOLELY IN THE PROVINCE OF ONTARIO, CANADA AND THEY FURTHER AGREE THAT THE SUBSTANTIVE LAW OF ONTARIO WILL APPLY WITHOUT REGARD TO CONFLICT OF LAW RULES.
THE PARTIES EXPRESSLY AGREE THAT THIS AGREEMENT IS INTENDED TO BE AS BROAD AND INCLUSIVE AS IS PERMITTED BY LAW AND THAT IF ANY OF ITS PROVISIONS ARE HELD TO BE INVALID, THE BALANCE SHALL, NOTWITHSTANDING, CONTINUE IN FULL LEGAL FORCE AND EFFECT.

I HAVE READ AND AGREE TO BE BOUND BY PARAGRAPHS 5-8

ACKNOWLEDGEMENT
THE PARTIES ACKNOWLEDGE THAT THEY HAVE READ THIS AGREEMENT AND UNDERSTAND IT, THAT THEY HAVE EXECUTED THIS AGREEMENT VOLUNTARILY, AND THAT THIS AGREEMENT IS TO BE BINDING UPON THEMSELVES, THEIR HEIRS, THEIR SPOUSES, PARENTS, GUARDIANS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, AND LEGAL OR PERSONAL REPRESENTATIVES.

READY TO SUBMIT (STEP 6 OF 6)

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Form Completed By (First Name) *

Form Completed By (Last Name) *

It is okay to keep me up to date on various items via call/text.

It is okay to keep me up to date on various items via email.

The information I provide here is accurate *