2025 West Coast Regional Camp

CONSENT, WAIVER AND RELEASE, AND INDEMNITY AGREEMENT

WHEREAS the Participant named below wishes to participate in the West Coast Regional Camp

to be held in Coquitlam and Port Coquitlam, British Columbia, Canada on December 5th, 6th and 7th,

2025 (the “ 2025 Regional Camp”), organized by the West Coast Goju-Kai Karate (“the 2025 Regional Camp 

Organizer”); and

THEREFORE, in consideration of the Participant’s participation in the 2025 Regional Camp, and for other good

and valuable consideration, , the Participant and the Guardian (if participant is underage)

hereby record and acknowledge the following:

CONSENT

1. I acknowledge that numerous risks, dangers and hazards are inherent in the 2025 Regional Camp

and attendant activities, namely: death or personal bodily or head injury, whether serious, permanent,

or life-threatening or not, including without limitation bruises, strains, sprains, bleeding, and broken

bones, howsoever caused, whether by other competitors, brutality in competition, by slip-and-fall or

other loss of balance or control, by unforeseen actions or inactions by other participants or

Organizer, coaches, or managers, or by equipment failure, misuse, or failure to use; food poisoning;

property damage and/or loss; physical, emotional and mental issues; dehydration and over-hydration;

self-administration of first aid; the effects of the weather, including the possibility of fire, hurricane,

flood, storms and other natural disasters or events outside of human control, or other events of force

majeure; risks involved in public and private transportation of any kind to activities of the 2025 Regional Camp;

the condition of the 2025 Regional Camp facilities; and risks of civil unrest, and the criminal acts of others,

including terrorism (“the Risks”). I agree such Risks are fully familiar to the Participant.

2. I freely consent to the Participant’s participation in the 2025 Regional Camp and attendant activities,

despite the Risks. I freely accept and fully assume all such Risks, and to take full responsibility for the

safety and well-being of the Participant.

3. I acknowledge and agree that the Participant should not participate in the 2025 Regional Camp unless

he/she is medically able.

4. In case of any medical emergency involving the Participant, I consent to the release of any and

all medical information regarding the Participant, as the case may be, to the authorized medical

personnel at the 2025 Regional Camp, and at the location of any of its attendant activities, and at any hospital

or other medical facility, that is required for such personnel to perform all necessary treatments for the

benefit of the Participant.

5. I consent for the 2025 Regional Camp Organizer to use the image, likeness, video, photograph, and/or

other recording, and/or the name of the Participant for lawful purposes, which include without

limitation such purposes as publicity, illustration, advertising, and website content.

6. Pursuant to the above consent, the Participant/Guardian waives any and all entitlement to

institute legal action against the 2025 Regional Camp Organizer, its directors, officers, partners,

instructors, coaches, leaders, volunteers, staff, committees, employees, representatives,

contractors, members, other parents/guardians, other participants, and any others participating in or

associated in any capacity directly or indirectly with or in the 2025 Regional Camp, together with all of their

respective successors, assigns, personal representatives, heirs, next of kin, administrators,

representatives and executors (collectively “the Released Parties”), under any circumstances

whatsoever, for any claim, loss, damage, misadventure, harm, loss, inconvenience, or personal injury

(fatal or otherwise), howsoever arising and of whatsoever nature and sustained (“the Claims”), by

the Participant, or any third party, arising directly or indirectly from the Participant participating in the

2025 Regional Camp, whether as participant per se, spectator or otherwise, irrespective of whether or not

some may have been caused or constituted by the Risks, or any willful act, omission, negligence

(including gross negligence), or default.

7. The Participant/Guardian releases and discharges each of the Released Parties from and against:

any and all such Claims; from any responsibility or blame for any item of property that the Participant

own or which is in the possession of the Participant that may be lost, damaged and/or stolen; and from

any and all Claims that may arise or be occasioned by any first aid or medical treatment or services

rendered to the Participant.

INDEMNITY

8. The Participant hereby indemnifies and holds harmless the Released Parties from and against

any and all Claims arising directly or indirectly from the presence of the Participant, and/or the

Participant participating in the 2025 Regional Camp whether as participant per se, spectator or otherwise,

irrespective of whether or not same is foreseen or unforeseen, known or unknown, or may have been

caused or constituted by the Risks, or by any willful act, misconduct, breach of contract, breach of duty

of care, omission, negligence (including gross negligence), or default.

ACKNOWLEDGMENT

9. I acknowledge and understand the above Consent, Waiver and Indemnity and the extent and

import thereof, and that the acceptance of the Risks is fair and reasonable given the nature of the

2025 Regional Camp and attendant activities.

10. This Agreement is effective and binding upon the heirs, next-of-kin, executors, administrators,

assigns and representatives of, and anyone else who may claim on behalf of the Participant, and is non-

transferable.

11. The law of the Province of British Columbia governs the interpretation and adjudication of this

Agreement, and the courts of the Province of British Columbia have exclusive jurisdiction over this

Agreement.

SIGNED ON                        , 2025

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Participant Signature                                      Print Participant Name

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