Birthday Party Registration "*" indicates required fields Host Name* First Last Phone*Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email* Enter Email Confirm Email Party Date Preference*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920NOTE: Birthday Parties on held on Saturdays only. 12:00pm - 1:30pmGuest of Honor Name* First Last Guest of Honor Age* Number of Attendees*12345678910111213141516Release of Liability and Assumption of Risk* I agree to the Release of Liability policy.MARIN DOJO, INC. Customer Release of Liability and Assumption of Risk *** THIS IS A CONTRACT – READ BEFORE SIGNING *** In consideration of being permitted by MARIN DOJO, INC. to participate in its activities and to use its equipment and facilities, now and in the future, I (and/or the minor of whom I am the parent or legal guardian) hereby agree to release, indemnify and discharge MARIN DOJO, INC., its agents, owners, shareholders, directors, partners, employees, volunteers, vendor and manufacturers of equipment and objects located on its premises, participants, lessors (including but not limited to Ongaro Properties Partners II, LLC, San Anselmo Properties TIC), affiliates, its subsidiaries, related and affiliated entities, successors and assigns and the Town of San Anselmo (the “RELEASED PARTIES”), on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate as follows: I acknowledge that my participation (and/or the participation of a minor of whom I am the parent or legal guardian) in MARIN DOJO, INC. martial arts and exercise activities entail known and unknown risks that could result in physical or emotional injury, paralysis, death, or damage to myself, to property or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. I VOLUNTARILY ASSUME ALL RISK KNOWN AND UNKNOWN, OF INJURIES, HOWEVER CAUSED, EVEN IF CAUSED IN WHOLE OR IN PART BY THE ACTION, INACTION, OR NEGLIGENCE OF THE RELEASED PARTIES TO THE FULLEST EXTENT ALLOWED BY LAW. The assumed risks include, among other things: martial arts and other exercise activities, which entail certain risks, including but not limited to strenuous physical activity, interpersonal touching, combat, kicking, punching that simply cannot be eliminated without jeopardizing the essential qualities of the activity. Also, if you or your child is injured, you or your child may require medical assistance, at your own expense. ** COVID-19/INFECTIOUS DISEASE DISCLOSURES ** MARIN DOJO, INC. has implemented additional health and safety protocol applicable to staff and members to limit the transmission of the novel coronavirus, as recommended by the Centers for Disease Control. Expressly included in this Release of Liability and Assumption of Risk form is a waiver of any claims against MARIN DOJO, INC. for any injuries or illnesses related to the novel coronavirus and any other infectious diseases. ** Furthermore, MARIN DOJO, INC. agents and employees have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of a participant’s fitness or abilities. They may give incomplete warnings or instructions, and the equipment being used might be defective, become loose, worn, out of adjustment, or malfunction. There is also a risk that MARIN DOJO, I NC. employees may be negligent in, among other things, monitoring and supervising martial arts and other exercise activities and use of its equipment and facilities and in the maintenance and repair of its equipment and facilities. I (and/or the minor of whom I am the parent or legal guardian) expressly agree and promise to accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate in spite of the risks. I (and/or the minor of whom I am the parent or legal guardian) hereby voluntarily release, forever discharge, and agree to defend, indemnify and hold harmless RELEASED PARTIES from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of MARIN DOJO, INC. equipment or facilities, including any such claims which allege negligent acts or omissions of RELEASED PARTIES. Should MARIN DOJO, INC. or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I (and/or the minor of whom I am the parent or legal guardian) agree to indemnify and hold them harmless for all such fees and costs. This means that I will pay all of those attorney’s fees and costs myself. I (and/or the minor of whom I am the parent or legal guardian) certify that we have adequate insurance to cover any injury or damage that we may cause or suffer while participating, or else we agree to bear the costs of such injury or damage myself. We further certify that we are willing to assume the risk of any medical or physical condition that I may have. I (and/or the minor of whom I am the parent or legal guardian) agree as an adult participant, or the Parent/Legal Guardian of a minor participant, in consideration of being permitted to participate at MARIN DOJO, INC., grant MARIN DOJO, INC., and all RELEASED PARTIES, the irrevocable right and permission to photograph and/or record me or my child(ren)/ward(s) in connection with MARIN DOJO, INC. to use the photograph and/or recording for all purposes, including advertising and promotional purposes, in any manner in any and all media now or hereafter known, in perpetuity throughout the world, without restriction as to alteration. I waive any right to inspect or approve the use of the Photograph and/or Recording, and acknowledge and agree that the rights g ranted to this release are without compensation of any kind. All Photographs and/or Recordings are exclusive to MARIN DOJO, INC. If the participant is a minor, I agree that this Release of Liability and Assumption of Risk agreement (“RELEASE”) is made on behalf of that minor participant and that all of the releases, waivers and promises herein are binding on that minor participant. I represent that I have full authority as Parent or Legal Guardian of the minor participant to bind the minor participant to this agreement. If the participant is a minor, I further agree to defend, indemnify and hold harmless MARIN DOJO, INC. from any and all claims or suits for personal injury, property damage or otherwise which are brought by, or on behalf of the minor, and which are in any way connected with such use or participation by the minor, including injuries or damages caused by the negligence of RELEASED PARTIES, except injuries or damages caused by the intentional or willful misconduct of the party seeking indemnity. In consideration of not being required to sign a fresh copy of this RELEASE before each visit, I further agree that this RELEASE shall apply to all future visits by me and by the minor participant until he/she is 18 years old in full, including Paragraphs 8 and 9. By signing this document, I acknowledge and agree that if anyone is injured or property damaged during or as a result of my participation in this activity, I may be found by a court of law to have waived my, or the minor participant’s, right to maintain a lawsuit against MARIN DOJO, INC. or any RELEASED PARTIES on the basis of any claim from which I have released them herein. I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms. In the event that any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.