Adult Waiver

Please fill in the required fields, read the following carefully, choose “I accept” or “I do not accept”, and then click on submit.

If you have not received a uniform yet:

How did your hear about us?

Is there any medical or physical condition we should be aware of?
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If yes, please explain:

What are the three main reasons you are interested in Aikido?

  1. I hereby RELEASE AND DISCHARGE, Aikido of Maine, Aikido Schools of Ueshiba, their owners, agents, employees and instructors (collectively referred to as “Released Parties”), from any and all liability, claims, demands or causes of action that I may hereafter have for injuries and damages arising out of my participation in martial arts activities, including but not limited to losses CAUSED BY THE NEGLIGENCE OF THE RELEASED PARTIES.
  2. I further agree that I WILL NOT SUE OR MAKE A CLAIM against the Released Parties for damages or other losses sustained as a result of my participation in the Martial Arts. I also agree to INDEMNIFY AND HOLD THE RELEASED PARTIES HARMLESS from all claims, judgments and costs, including attorneys’ fees, incurred in connection with any action brought as a result of my participation in the Martial Arts.
  3. I understand and acknowledge that the Martial Arts have inherent dangers that no amount of care, caution, instruction or expertise can eliminate and EXPRESSLY AND VOLUNTARILY ASSUME ALL RISK OF PERSONAL INJURY OR DEATH SUSTAINED WHILE PARTICIPATING IN THE MARTIAL ARTS WHETHER OR NOT CAUSED BY THE NEGLIGENCE OF THE RELEASED PARTIES.
  4. I hereby expressly recognize that this Agreement and Release of Liability is a contract pursuant to which I have released any and all claims against the Released Parties resulting from my participation in the Martial Arts including and an all claim caused by the negligence of the Released Parties.
  5. I expressly agree that this Agreement and Release of Liability is intended to be as broad and inclusive as permitted by the laws of Maine and that, if any portion of the Agreement is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.
  6. I hereby release all officials and professional personnel from any claim whatsoever on account of first aid, treatment or service rendered me during participation in Martial Arts.
  7. I was advised and recognize that instruction in the Martial Arts involves strenuous exercise and personal body contact with the inherent risk of injury, including, but not limited to, pulled muscles, dislocated joints, and broken bones, or even albeit rare, spinal and/or head injuries that cannot be eliminated.
  8. I was also advised that in accordance with the law, the Released Parties do not exclude individuals with medical conditions that do not pose a medically recognized threat to the health or safety of other students in the normal course of training. I understand that there are some unavoidable circumstances where these conditions may require special caution on my part to minimize danger to others, or myself and I acknowledge that it is my responsibility to act accordingly.
  9. In particular, I understand that some students may be infected with diseases such as HIV/AIDS and hepatitis that can be transmitted by exchanges of blood or other bodily fluids and that I may be training with them. I acknowledge that I have read and will follow the Released Parties’ procedures (see, below, Blood Borne Pathogen Policy) for dealing with injuries to others, or myself that present opportunities for exposure to blood or body fluids.
  10. I understand that the Martial Arts is an educational system. For the safety of myself and other members, I will practice in a considerate and conscientious manner and strictly follow all rules established by the Released Parties. Should I break any of these rules, I understand that it is the decision of the head instructor whether I may continue training. I will abide by that decision.
  11. This release contains the entire agreement between the parties and the terms are contractual and not a mere recital.
  12. I HAVE READ THIS AGREEMENT AND SIGN IT OF MY OWN FREE WILL. I FULLY UNDERSTAND ITS CONTENTS AND MEANING AND HEREBY DECLARE MYSELF TO BE PHYSICALLY SOUND WITH MEDICAL APPROVAL TO PARTICIPATE IN THE MARTIAL ARTS.
  13. This release contains the entire agreement between the parties and the terms are contractual and not a mere recital.

I make this agreement on behalf of myself, my heirs, successors, executors, estate, and dependents. By clicking on "Accept", I am asserting that I am over 18 years of age, and that I am an adult.

Photo/Video Release
I hereby grant Aikido of Maine permission to use my likeness in photographs, video or other digital reproduction in any and all of its publications, including website entries, without payment or any other consideration. I understand that any photographs/videos/digital reproductions using my likeness may be used for promotional and/or informational purposes.
I make this agreement on behalf of myself, my heirs, successors, executors, estate, and dependents. By clicking on "Accept", I am asserting that I am over 18 years of age, and that I am an adult.

Blood Borne Pathogen Policy
Please Read Carefully
To protect the dojo family against disease, Aikido of Maine has adopted the following policy intended to minimize the risk of transmission of HIV, Hepatitis-B and other blood borne pathogens during training activities. Current available medical evidence suggests that the risk of transmission of HIV during the type of contact that occurs in Aikido training is extremely slight. Organizations such as the NCAA, the National Academy of Pediatrics Committee on Sports Medicine, and the U.S. Olympic Committee have concluded that persons affected with blood-borne pathogens, particularly HIV, should not be barred from participating in contact sports. Certain federal and state anti-discrimination laws may also prohibit such a ban. These organizations have also concluded that the already slight risk of transmission of HIV and other blood-borne pathogen diseases can be reduced further by the adoption of the Center for Disease Control-recommended “Universal Precautions”. This Dojo will observe these “Universal Precautions”. Generally this means that instructors and persons training in this dojo shall treat all exposed body fluids as if they were infected. Specifically, the following measures will be observed at all times:

  1. If you have any open cuts or sores, you must clean them with a suitable antiseptic and cover them securely with a leakproof dressing before coming onto the mat. Make sure that the cut or sore stay covered while you are training. If your hands or feet have broken skin, suitable gloves or tabi may be worn to cover these areas. If you notice that someone else has an open cut or sore remind them of their obligation before training with that person.
  2. If a bleeding wound, even a minor one, occurs during training, the person bleeding shall immediately stop training and leave the mat until the bleeding stops and the wound is securely covered. Immediate measures shall be taken to stop the bleeding. If the person needs assistance with this then each person assisting shall wear a pair of latex gloves (which are available in the dojo first aid kit). Hands shall be washed with soap and hot water immediately after gloves are removed. All used gloves, bloody dressings and rags, etc shall be placed in a leakproof plastic bag provided for that purpose. All contaminated items should be disposed of carefully. Minor bloodstains on Gi should be treated with a disinfectant provided for this purpose. If there are major blood stains the Gi shall be removed as soon as possible, placed into a leakproof container and handled carefully until it can be laundered or disposed of.
  3. If you come into contact with the blood of another, you shall immediately stop training, leave the training area and wash the exposed area thoroughly with soap and hot water before returning.
  4. If blood is present on the mat, the training partner of the person bleeding shall insure that no one inadvertently comes into contact with the blood, while the bleeding person attends to his injury (in accordance with #2, above). The blood should be cleaned up as soon as possible by wiping the exposed surface with a disinfectant solution provided for this purpose. Each person assisting with this task shall put on a pair of latex gloves and shall wash their hands with soap and hot water immediately after the gloves are removed. It is preferable however that the person bleeding clean their own blood. Bloody rags and used gloves shall be disposed of as set out in Paragraph 2.

Finally, there are other diseases and illnesses aside from those transmitted through blood. You are reminded that you are responsible for not only your own health and safety but the health and safety of others with whom you train. If you know or suspect that you have any illness or disease which might infect others, please refrain from training until you are no longer a risk to others. This self-defense and consideration of yourself and your fellow Budoka is your responsibility and part of your training. It is embodied in the spirit of the Budo we study.
I make this agreement on behalf of myself, my heirs, successors, executors, estate, and dependents. By clicking on “Accept”, I am asserting that I am over 18 years of age, and that I am an adult.

 accept do not accept

Aikido of Maine  |  226 Anderson street  |  Portland, Maine 04101  |  207.879.9207
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