Physical Readiness QuestionaireHas your doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor? Do you feel pain in your chest when you do physical activity? In the past month, have you had a chest pain when you were not doing physical activity? Do you lose your balance because of dizziness or do you ever lose consciousness? Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? Is your doctor currently prescribing medication for your blood pressure or heart condition? Do you know of any reason why you should not partake in sparring or pair work? Do you know of any other reason why you should not partake in physical activity/self defence/martial arts training?
Informed Consent WaiverI understand that although every care is take by all instructors to eliminate all hazards and the possibly of sustaining injury though contact with other students when sparring and in classes, it is impossible to completely remove the risks involved in a contact sport/activity. I understand that taking part in the activity has the risk of sustaining injury through other means such as but not limited to; running, tripping or pulling muscles/ligaments. By signing this form, I agree that I have been informed that I should not participate in any activity if I have any doubt or if I am uncertain as to my current medical condition. I understand that I should always seek medical advice before starting any physical training program. I understand that the activities in which I participate are physically and mentally intense and may require extreme exertion and give rise to the possibility of injury. I hereby certify that I am in good health and do not suffer from any heart condition or other ailment that could be exacerbated by the exertion involved in the activities in which I participate. I confirm and agree that I am fully aware of the risk and certify that I am physically able to participate in this organization’s activities. I further agree that I will comply with all the rules, regulations, and instructions given to me by any instructor. I understand that this covers all classes and seminars that I attend. I voluntarily assume full responsibility for any risks or loss, property damage, or personal injury, including death, that may be sustained by me during this activity. I confirm that I will not hold IKM or any of its instructors or representatives responsible for any injury sustained by me. *If under 16 years I the parent/guardian of the above named student give permission for them to participate in classes and agree to the above and term & conditions.
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