SKIA Karate Class

Participation Consent and Risk Acknowledgement

This form records consent for a participant to take part in a Shotokan Karate International Australia Incorporated (SKIA) karate class, and collects the health and emergency details instructors need to run the class safely. Please complete all required fields.

1Participant and class details

Tell us who is taking part and which class this is for.

Please select Yes or No.

2Activity and risk warning

Important risk warning

Karate is a strenuous physical and contact activity. Taking part in a SKIA karate class involves risks that cannot be entirely removed, even with reasonable instruction and precautions. These risks include, but are not limited to:

  • strenuous physical activity, fatigue and overexertion;
  • slips, trips and falls;
  • contact or accidental contact with other people, floors, pads or equipment;
  • incorrect execution of movements or techniques;
  • strains, sprains, bruising, cuts and joint or muscle injuries;
  • fractures, concussion, serious injury, permanent disability and, in rare cases, death;
  • aggravation of an existing or previously unknown medical condition; and
  • risks that arise despite reasonable instruction and precautions.
Please stop and contact SKIA before submitting if you do not understand this warning, cannot safely participate, or need the information in another format or language.

3Health and emergency information

This helps instructors keep the participant safe and respond in an emergency.

Please select Yes or No.
Providing this information does not mean SKIA has medically cleared the participant. If unsure whether participation is safe, please obtain medical advice. The participant must follow instructor directions, work within their ability, and immediately report any pain, illness, dizziness or injury.

4Acknowledgement

Release and exclusion

To the extent permitted by law, and having read the risk warning above, I participate voluntarily and accept the inherent risks of the activity. To the maximum extent permitted by law, including provisions relating to recreational services and recreational activities, I agree that SKIA, its instructors, officers and volunteers are not liable for harm resulting from the materialisation of an obvious or inherent risk of the activity. Nothing in this acknowledgement excludes any liability that cannot be excluded by law, including liability for significant personal injury caused by reckless conduct.

5Electronic signature

By entering my full legal name and selecting "Submit response" below, I confirm that I intend to sign this acknowledgement electronically and be bound by its terms.

6Optional permissions

These are optional. Declining them will not prevent participation in the class.

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Acknowledgement recorded

Thank you. Your acknowledgement has been recorded. Please tell the instructor before the class if any information changes or if the participant needs an adjustment.