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Registration for Specialty Classes, Workshops or Seminars

Seattle Wushu Center / Ascension Martial Arts

By clicking on the "submit" button below, I state that I have read and agree by these terms for myself and/or my child(ren):


I/We, the undersigned, understand that knife throwing, blowgun shooting, bullwhip cracking,and any martial arts related activity, whether with or without training apparatus or training weaponry, is an activity that may involve potential injury or damages to participants and property. For this specialty class, workshop or instructional event, I/We agree to abide by all safety rules, regulations, and advice as set forth by Ms. Restita DeJesus, Ms. Kathleen Long, Seattle Wushu Center and it's affiliateAscension Martial Arts, all designated officers, assigns, and assistant coaches of both venues. I agree to hold the above named parties harmless of any and all injuries and damages to my/our physical bodies and property, whether such injuries/damages are: accidental, a result of my/our failure to comply with safety regulations, my/our personal decision to attempt martial arts techniques not yet taught to me, caused by my/our inattentiveness or lack of skill, or caused by another participant. I understand that any damages, injuries or loss of income sustained under the aforementioned reasons are my financial responsibility and that I will not sue Ms. Restita DeJesus, Ms. Kathleen Long, Seattle Wushu Center and it's affiliate Ascension Martial Arts, all designated officers, assigns, and assistant coaches of any damages. I understand that I/We will be given several warnings if I/we fail to comply with safety regulations, and that I may be ejected from this workshop/activity at the Instructor's decision after several warnings have been given. I understand that no refund or reimbursement of my workshop fees will be given if I/we are ejected from this activity.


By printing my name and or any other associated family member's names below and clicking the "submit" button, it acts as my signature of permission and authorization for myself and/or the named family members to attend this event; and acts as an agreement to abide by all the statements as printed above. I understand that this permission and agreement is binding when this document is received via electronic mail by Seattle Wushu Center /Ascension Martial Arts.

Select specialty class

Participant Name (primary)*

Age of primary participant (must be 8 years old or older)*

Additional Participant (1) Name (type N/A if not applicable)

Age of additional participant (must be 8 years old or older)

Additional Participant Name (2) (type N/A if not applicable)

Age of additional participant (must be 8 years old or older)

Parent/Legal Guardian Name (if Participant is under 18 years of age)

email address

Phone #

(check here)*

Signed: (Print Name)*

Today's Date*

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