Online Registration Form

Please complete the registration below. (Versión en Español)

Participant Information

Parent/Guardian Information

Mother/Father etc.

Contact Information

The best number to contact you

Emergency Contact Information

I, the adult student, or guardian of the minor student listed above, do consent and agree that SOUTH COAST KARATE ORGANIZATION, and any sponsoring organization, facility instructor, and any other party involved are hereby released and held harmless from all claims and liability due to any injuries and/or damages I may suffer as a result of ordinary negligence or carelessness including the risk that are incidental to the participation in the karate program. Student and/or guardian is familiar with the risks associated with this sports program and assumes these risks. It is acknowledged that negligent and even careless conduct is an inherent risk of this sport.

It is further agreed that student or guardian will defend, indemnify and hold harmless SOUTH COAST KARATE, and its employees, from any claims arising from injury caused by student.

The Undersigned hereby grants the SOUTH COAST KARATE ORGANIZATION, without expectation of compensation of any kind, the unrestricted right and permission to copyright and use, re-use, publish, and republish photographic portraits or pictures.

I hereby warrant and certify that I am the parent or guardian of the Minor, and do hereby give my consent, without reservation, to the foregoing on behalf of the Minor.

Download and print the Registration Form (English & Spanish)