Kung Fu Regina Waiver and Consent to Participation


I understand and agree to observe all rules and regulations and further agree that rules and regulations may be changed without notice to me. I understand and agree that, with approval of my application, any violation of the said rules and regulations may be cause for the suspension or termination of my membership.


I understand and agree that I undertake all exercises and activities solely at my own risk and that I hereby forever release and discharge Kung Fu Regina, its officers, directors, members, servants, agents, and employees, hereinafter referred to as Kung Fu Regina, from any claim of cause or action arising out of any injury to myself or to my property resulting from the use of services or facilities and/or from any act of negligence on the part of its members or employees.


I understand and agree that Kung Fu Regina shall not be held responsible for any loss or theft of my personal possessions.


I state that to the best of my knowledge I am in good physical and mental health and that there is nothing to prevent me from following the instructions of and participating in the activities and programs as offered.

I hereby state that all personal information given herein is true. I understand that it is recorded strictly for registration purposes and will be remain strictly confidential.


I understand that I may cancel this contract at within fourteen days for full refund of applicable fee portions in accordance with refund policies of Kung Fu Regina.

I understand and agree that this waiver shall be binding upon my heirs and my personal representatives.


If the Applicant is under the age of eighteen: I, the parent or legal guardian of the Applicant, hereby apply for and request membership on behalf of the Applicant, and agree to the terms for membership.

Pledge of Ethical Behaviour

I hereby declare that I enroll in the programs as offered by Kung Fu Regina by my own free will.  


I promise not to use what I learn to bully and intimidate, or to engage in hurtful or illegal activity.


I promise to take full responsibility for any harm I bring to others and will make amends for my actions.


For all that I learn, I will devote myself in good faith, respect, hard work, patience and perseverance.


I pledge to use what I learn for good, just and compassionate cause.


I will bring honour to my teachers and School, and to the art though my noble actions and dedication.

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Kung Fu Regina 1813 Halifax Street        306.525.5027

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