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Greetings Mandeville Karate Student,

.....Notice: This agreement contains indemnity and release provisions. In submitting this application, I (students){name}  am physically able to participate in any and all athletic endeavors and have not been directed by a medical authority against an activity of this type. I also understand that Karate, as in all athletic activities, there is always the chance of injury. I hereby release Mandeville Karate, Scott Shook, and all other members and participants of liabilities of this nature. {sign_date}