American Shotokan Karate Alliance ASKA ONLINE INDIVIDUAL MEMBERSHIP APPLICATION

American Shotokan Karate Alliance (ASKA) Home Page

Online Individual Membership Application

To apply for individual membership in the ASKA, please fill in the form below (enter the full name of the member as you wish it to appear on the Membership Card), then read and electronically "sign" the release waiver below. Upon clicking the button labeled "ACTIVATE MY MEMBERSHIP!" you will be directed to our Secure Shopping Cart to enter your payment details (Individual Membership Cost is $15.00 per year). REQUIRED FIELDS ARE MARKED IN BOLD.

NOTE: To enroll multiple members with one payment, such as family members or an instructor paying for multiple registrants, simply revisit this page, after viewing your shopping cart for each applicant, the needed number of times.

Please Indicate Your Membership Status:

Please Indicate If This Membership is For Yourself, Your Student (only if you are the Instructor), or for Your Child Under 18 Years of Age:

Please Select The Applicant's Current Ranking Level:

Applicant's First Name:

Applicant's Middle Initial:

Applicant's Last Name:

Applicant's Club's Name:

Applicant's Instructor's Name:

WAIVER AND RELEASE

I, intending to be legally bound hereby and as a condition of membership in the American Shotokan Karate Alliance, LLC (hereinafter referred to as Alliance) do hereby release said Alliance, the members, instructors and representatives thereof, from any and all claims, liabilities, obligations, causes of action or demands that I or my administrators, executors, heirs or assigns may at any and all times hereafter have or obtain, due to or as a result of, any personal injury or bodily harm sustained or suffered by me during, arising out of or as a result of any karate activity, physical or athletic activity, or physical instruction or sport conducted or carried on by or for said Alliance, either by itself or by others. I further agree to indemnify and save harmless said Alliance, its members, instructors and representatives from any act committed or omitted by me during or arising out of or as a result of any activity carried on or participated in by said Alliance. I further release said Alliance, its members, instructors and representatives from all claims of liability for any property or valuable lost, mislaid or stolen.

I also hereby grant said Alliance to use, without compensation to me, any photographs, videotapes, motion pictures, or digital images of me, which are taken or created during the course of my regular training or during my participation in any activities carried on by said Alliance.

BY CLICKING ON THE "ACTIVATE MY MEMBERSHIP" BUTTON BELOW, I AM ELECTRONICALLY SIGNING THIS FORM, FULLY REALIZING THAT MY (OR MY CHILD UNDER 18 YEARS OF AGE) PARTICIPATION OR ENGAGEMENT IN THE ACTIVITIES OF SAID ALLIANCE MAY SUBJECT ME TO PERSONAL INJURY OR BODILY HARM.

IF YOU ARE AN INSTRUCTOR APPLYING ON BEHALF OF A STUDENT, THEN CLICKING THE "ACTIVATE MY MEMBERSHIP" BUTTON WILL BE CONDITIONAL --- PLEASE DOWNLOAD A COPY OF THE WAIVER AND RELEASE BELOW FOR THE MEMBER TO SIGN AND RETURN BEFORE THE MEMBERSHIP WILL BE ACTIVATED. Download a copy of it now by using this link.

I HAVE READ THE CONTENTS OF THE ABOVE RELEASE INDEMNITY, AND I UNDERSTAND THE MEANING THEREOF.

NOTE: The Waiver and Release download link above requires the Free Adobe Reader (available for multiple platforms). Click the button below to get Adobe Reader for FREE!