A. I, the undersigned, knowingly, without duress, do voluntarily submit this request for membership in the Shaolin Temple.

B. I assume all risk and expressly agree that the Shaolin Temple shall not be liable for any damages arising from personal injuries sustained by me on or about the premises of the Shaolin Temple facilities or as a result of participating in the activities using the facilities and the equipment therein. By the execution of this agreement I assume full responsibility of any such injuries or damages which may occur to me, in, on or about the premises of the said facilities and further agree the Shaolin Temple shall not be liable for any loss, theft or damage to personal property. Acting for myself, my heirs, personal representatives and assignees, I hereby fully and forever release and discharge the Shaolin Temple and any party thereto, including but not limited to the Shaolin Temple, all associated facilities, their owners, administrators, instructors, directors, officers, employees, members, attorneys, affiliates and agents from any and all legal or administrative claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, unanticipated, resulting from or arising out of my use or intended use of the said activities, facilities and equipment thereof.

C. This member applicant warrants, represents and agrees that I am in good physical condition and that I have no disability, impairment or ailment preventing me from engaging in active or passive exercise or will be detrimental or inimical to my health, safety, comfort, or physical condition if I do so engage or participate.

D. I consent to the use of photographs and/or video recording of my participation in the activities performed in connection with this membership, and hereby waive my rights to any form of compensation or claim.

E. Membership violations: I agrees to keep and obey all rules and regulations now in force or in the future prescribed by the Shaolin Temple of its associated facilities for the use of facilities and the equipment therein, and the Shaolin Temple reserves the right to revoke this membership for cause if member fails to keep and obey any of such rules and regulations. Membership privileges may be suspended or revoked at the reasonable discretion of the Shaolin Temple management for a member's breach of membership rules or regulations, other undesirable behavior, or violations of the terms and conditions of this membership agreement.
F. I agree to never teach martial arts, with the exception that I obtain expressed written permission from the Director of the Shaolin Temple of Michigan.

G. Assignee of this agreement is hereby authorized to correct patent errors in this agreement (and in other documents, if any executed in connection herewith).


Applicant Information and Signatures:

Applicant Signature: ____________________________________

Applicant Print Name: ___________________________________

Home Address _________________________________________

City, State, Zip _________________________________________

Telephone: ________________________

Email: ___________________________________

Date Signed: _______________________

Guardian Signature: _____________________________________

(If applicant is under 18 yrs of age)

Guardian Print Name: ____________________________________

Date Signed: _______________________