Thanks for registering. Don't forget to keep your tickets handy, either in the Eventbrite app or print them out and bring them with you. Please make sure you fill out this waiver form at the required link and bring that also to the event. Note: For students please bring ID Please print and fill out the waiver form below and bring it with you to the seminar.

CHINESE KUNG-FU, WU-SU ASSOCIATION

SELF-DEFENSE SEMINAR

(REGISTRATION/ LIABILITY WAIVER FORM)

 

General Information

 

NAME

Last

First

Middle

ADDRESS

Street

 

 

 

City

State

Zip code

 

Date of Birth: ________________ Age: _____ Sex: Female _____ Male____

 

Married: ________ Single: ________ Divorced: ________ Separated: ________

 

Email: __________________________________________________________

 

Phone: ________________________________ Other Phone: ________________________________________

 

Experience in Martial arts: Y: ___ N: ___ System/ Style/ Rank: _____________________________________

 

 

Emergency contact Information:

 

Name: __________________________________ Phone: ___________________________________________

 

LIABILITY WAIVER

Event Name/Activity Description: Self-Defense Seminar

Event/Activity Date(s): March 21st and 22nd, 2026

Event/Activity Location: 28 W 27Street 8TH Floor, NY, NY 10001

 

For and in consideration of Chinese Kung-Fu, Wu-Su Association allowing me, the undersigned, to participate in the event or activity described above (Self Defense Seminar);

 

I, for myself, and on behalf of my spouse, children, guardians, heirs and next of kin, and any legal and personal representatives, executors, administrators, successors and assigns, hereby agree to and make the following contractual representations pursuant to this Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement (the “Agreement”);

 

  1. I hereby represent that (i) I am at least eighteen (18) years of age or older; (ii) I am in good health and in proper physical condition to participate in the Event; and (iii) I am not under the influence of alcohol or any illicit or prescription drugs which would in any way impair my ability to safely participate in the Event. I agree that it is my sole responsibility to determine whether I am sufficiently fit and healthy enough to participate in the Event, that I am responsible for my own safety and well-being at all times and under all circumstances while at the Event site.
  2. I understand and acknowledge the risks and dangers associated with participation in the Event and the sport of Chinese Kung-Fu, Wu-Su Self-Defense Seminar, including without limitation, the potential for serious bodily injury, sickness and disease, permanent disability, paralysis and loss of life; loss of or damage to equipment/property; exposure to extreme conditions and circumstances; contact with other participants, inadequate safety measures; participants of varying skill levels; situations beyond the immediate control of the Event Organizers; and other undefined, not readily foreseeable and presently unknown risks and dangers (“Risks”). I understand that these Risks may be caused in whole or in part by my own actions or inactions, the actions or inactions of others participating in the Event, or the negligent acts or omissions of the Released Parties defined below, and I hereby expressly assume all such Risks and responsibility for any damages, liabilities, losses or expenses which I incur as a result of my participation in any Event.
  3. I understand that I am required to be familiar with and to abide by the Rules and Regulations established for the benefit and safety of all participants in the Event. I accept sole responsibility for my own conduct and actions while participating in the Event, and the condition and adequacy of my equipment. I understand that the Event Organizers have the right to disqualify anyone or deny participation in the Event for any reason they deem just and proper in their sole discretion.
  4. I hereby Release, Waive and Covenant Not to Sue, and further agree to Indemnify, Defend and Hold Harmless the following parties: [Chinese Kung-Fu, Wu-Su Association and Instructors (Individually and Collectively, the “Released Parties” or “Event Organizers”), with respect to any liability, claim(s), demand(s), cause(s) of action, damage(s), loss or expense (including court costs and reasonable attorneys fees) of any kind or nature (“Liability”) which may arise out of, result from, or relate in any way to my participation in the Event, including claims for Liability caused in whole or in part by the negligent acts or omissions of the Released Parties. I further agree that if, despite this Agreement, I, or anyone on my behalf, makes a claim for Liability against any of the Released Parties, I will indemnify, defend and hold harmless each of the Released Parties from any such Liabilities which any may be incurred as the result of such claim.
  5. By signing this release, I also agree to give permission to the Chinese Kung Fu, Wu-Su Association for the production, editing, distribution, alteration, reproduction of any photographic, digital and video content that is created during the event and that will include me as a participant. This noted content will be used for advertisement purposes in different media platforms, including but not limited to our website, social media (all current and future platforms that are made available for our use - and our discretion) and other means to promote the Chinese Kung Fu, Wu-Su Association organization. By this consent, I will hold the Chinese Kung Fu, Wu-Su Association and Instructor’s harmless of any unsolicited distribution of such media content acquired by entities or persons outside of the Chinese Kung Fu, Wu-Su Association organization through unauthorized downloading, file sharing, etc. All digital media described and published by our organization is owned by the Chinese Kung Fu, Wu-Su Association, protected through copyright laws and we reserve the right to grant or deny permission to use such material for any of the participants or people related or associated with the participants.

 

I hereby warrant that I am of legal age and competent to enter into this Agreement, that I have read this Agreement carefully, understand its terms and conditions, acknowledge that I will be giving up substantial legal rights by signing it (including the rights of my spouse, children, guardians, heirs and next of kin, and any legal and personal representatives, executors, administrators, successors and assigns), acknowledge

that I have signed this Agreement without any inducement, assurance or guarantee, and intend for my signature to serve as confirmation of my complete and unconditional acceptance of the terms, conditions and provisions of this Agreement.

 

This Agreement represents the complete understanding between the parties regarding these issues and no oral representations, statements or inducements have been made apart from this Agreement. If any provision of this Agreement is held to be unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from this Agreement and shall not affect the validity and enforceability of any remaining provisions.

 

X _____________________________________________________ _______/_______/____________

Signature

 

Print Name: ____________________________________________