USA Sports Jujitsu Alliance: USA Sports Jujitsu Alliance Membership

USA Sports Jujitsu® Alliance Membership

Please complete all information below.

MEMBERSHIP FEES:

USA Citizens - $15

International Members Required $35

Club Membership is $25

Instructions: Please be sure to fill out all fields and agree to terms and waiver information.

This page is for annual membership in The USA Sports Jujitsu Alliance.

This is a sports jujitsu organization representing the United States in International Jujitsu competition and providing a sports jujitsu environment in the United States.

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First Name

Last Name

Country

Address

City

State/Province

Zip/Postal

Phone

Billing and Payment
Billing and payment processing for Businesses' events is performed by Member Solutions, Inc. ("MSI"), and this contract is specifically assigned to MSI for all such purposes. Customer knowingly and irrevocably authorizes MSI to charge electronically Customer's bank account and/or credit card for any and all amounts due for Customer's, and anyone registering under Customer's, attendance and participation in the Event. Please note, you may see all or any portion of the following on your bank or credit card statement: "MSI*THEUSAKARATEFEDERATI 8882448044 ONLINE REG FEE". Any returned payment will be assessed a $25.00 fee. Any unsuccessful electronic transaction is subject to a $10.00 processing fee. MSI is not responsible for any bank fees incurred by Customer. MSI has the sole right to resubmit returned or declined items (plus applicable fees) without prior notice. BILLING INQUIRIES -- 888-244-8044 or by mail to PO Box 297, Hatboro, PA 19040.

Applicant Agreement
I represent that I am the person who appears on the application above. I acknowledge and agree to the statements, terms and conditions above, as well as any applicable terms and conditions for this registration, and that by typing my name below and completing this registration form, I am electronically signing the document, which will have the same legal effect as the execution of the document by a written signature and shall be valid evidence of my intent and agreement to be bound.

Applicant Signature
Please enter your full name in the space below.

Please click the button below to finalize your registration.

Registration inquiries:
USA Sports Jujitsu Alliance
1550 Ritchie Road
Stow, Ohio 44224 USA

or email USA Sports Jujitsu� Alliance.

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Registrant

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First Name

Last Name

Address

Address (line 2)

City

State

Zip

Country

Home Phone

Name of Dojo

Please Register my club ($25).

I am a US Citizen (select one)

I wish to make a voluntary membership fee donation of $15.

Style/Art

Gender

Date of Birth (MM/DD/YYYY)

__________________________________________________________

What date did you start training?

Name of Instructor

Belt color (if applicable)

Dan (if applicable - shodan, nidan, etc.)

Terms

By voluntarily agreeing to these terms I, the undersigned, state I have read the below waiver and release, understand that I have given up for myself and/or my minor child substantial rights by agreeing to the terms and conditions.

Amateur Athletic Waiver and Release of Liability
Required Form
In consideration of participating in any way in The USA Karate Federation athletics/sports program, and related events and activities, including USA Sports Jujitsu Alliance, USA Jujitsu, and others not named, the undersigned:
1. Agrees that prior to participating, they will inspect the facilities and equipment to be used, and if they believe anything is unsafe, they will immediately advise their coach or supervisor or USA Karate Federation personnel of such conditions) and refuse to participate.
2. Acknowledge and fully understand that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions or negligence but the actions, inactions or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time.
3. Assume all the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability or death.
4. Release, waive, discharge and covenant not to sue The USA Karate Federation, its affiliated
clubs, regional sports organizations, their respective administrators, directors, agents,
consultants, coaches, and other employees of the organization, other participants, sponsoring
agencies, sponsors, advertisers, and, if applicable, owners and lessees of premises used to
conduct the event, all of which are hereinafter referred to as "releasees" from any and all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury including death or damage to property, caused or alleged
to be caused in whole or in part by the negligence of the releasee or otherwise.

Check this box to indicate that you have read and agree to all of the above terms & conditions

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