Join DBTJ
New members must fill out this form before joining the club. For any questions, contact @ info@dbtjudo.com

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Name *
Age *
Gender *
Birthday
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/
DD
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YYYY
If minor, name of legal guardian
Email *
Phone *
Method of payment *
Have you or are you currently practicing another martial art? If so, what rank did you achieve?
Briefly explain why you wish to take judo *
TERMS AND CONDITIONS:
 THE $40 REGISTRATION FEE MUST BE PAID AT OR PRIOR TO THE START OF THE FIRST CLASS.

 PARTICIPANTS MUST OBTAIN A USA JUDO TRIAL MEMBERSHIP AND MUST SUBMIT A COPY OF PROOF OF
MEMBERSHIP PRIOR TO OR AT THE START OF THE FIRST CLASS.  MEMBERSHIP MAY BE OBTAINED VIA THIS LINK:

 CANCELLATIONS SHALL BE MADE BY EMAILING DBTJUDO@GMAIL.COM PRIOR TO THE START OF THE FIRST CLASS AND THE FULL $40 REGISTRATION FEE SHALL BE REIMBURSED.  NO FEES SHALL BE REIMBURSED FOR THE USA JUDO TRIAL MEMBERSHIP.  REGISTRATION FEE SHALL NOT BE REIMBURSED ONCE A SESSION COMMENCES.

 PARTICIPANTS ACKNOWLEDGE THAT JUDO IS A CONTACT SPORT AND PARTICIPANTS ASSUME ALL RISKS RELATED TO ENGAGING IN A CONTACT SPORT THAT MAY RESULT IN SERIOUS INJURY, PERMANENT DISABILITY OR DEATH, SOCIAL AND ECONOMIC LOSS DUE TO PARTICIPANT OR OTHER PARTICIPANTS ACTIONS, INACTIONS OR NEGLIGENCE, CONDITIONS OF THE FACILITY OR EQUIPMENT, OR OTHER RISKS NOT FORESEEABLE AT THIS TIME.

 PARTICIPANTS UNDERSTAND THAT THE CLASS IS COED AND PHYSICAL CONTACT WITH A PERSON OF THE OPPOSITE SEX IS INEVITABLE IN JUDO AS A CONTACT SPORT.    

 PARTICIPANTS MUST ATTEND ALL 8 BEGINNER’S SESSIONS TO BE ELIGIBLE FOR TRANSFER TO REGULAR PRACTICE.  PARTICIPANTS MUST INFORM THE INSTRUCTOR PRIOR TO CLASS FOR AN EXCUSED ABSENCE.  MAKE-UP SESSIONS ARE AT THE DISCRETION OF THE INSTRUCTOR.

 PARTICIPANTS WHO ARE ILL OR CONTAGIOUS WILL NOT BE ALLOWED TO PRACTICE UNTIL SYMPTOM FREE.

 PARTICIPANTS WILL BE ADMINISTERED AN EXAM AT THE END OF THE SESSION AND MUST DEMONSTRATE PROFICIENCY IN THE KNOWLEDGE AND SKILLS TAUGHT IN THE BEGINNER’S CLASS TO TRANSFER TO REGULAR PRACTICE.

 PARTICIPANTS ACKNOWLEDGE THAT SUCCESSFUL COMPLETION OF THE BEGINNER’S CLASS DOES NOT CORRELATE WITH ANY PROMOTION OR ADVANCEMENT TO A HIGHER GRADE OR BELT LEVEL.  FURTHER, UPON COMPLETION OF THE BEGINNER’S CLASS, SHOULD A PARTICIPANT DECIDE TO CONTINUE WITH THE DBT JUDO PROGRAM, THE PARTICIPANT UNDERSTANDS THAT:

 HE/SHE IS REQUIRED TO CONVERT HIS/HER USJI (USA JUDO) TRIAL MEMBERSHIP TO AN ANNUAL MEMBERSHIP AND WILL KEEP THE MEMBERSHIP CURRENT AND IN GOOD STANDING SO LONG AS HE/SHE IS AM A MEMBER OF THE DBT JUDO DOJO;

 HE/SHE IS REQUIRED TO OBTAIN A JUDO GI (PURCHASE OF A GI THROUGH THE DOJO IS NOT MANDATORY;

 THE MONTHLY DUES FOR REGULAR PRACTICE ARE $30 PER MONTH PER PARTICIPANT, $10 PER MONTH FOR EACH ADDITIONAL PARTICIPANT FROM THE SAME IMMEDIATE FAMILY;

 NON-MEMBERS OF THE TRI-STATE DENVER BUDDHIST TEMPLE ARE SUBJECT TO AN ADDITIONAL FEE OF $25.00/YEAR;

 THE DOJO SUPPORTS THE TRI-STATE DENVER BUDDHIST TEMPLE FROM TIME TO TIME IN NON-RELIGIOUS ACTIVITIES (NAMELY THE CHERRY BLOSSOM FESTIVAL AND TEMPLE SPRING CLEANING).  DOJO MEMBERS ARE EXPECTED TO LEND A HELPING HAND.

THE UNDERSIGNED UNDERSTANDS AND AGREES TO THE TERMS AND CONDITION SET FORTH IN THIS APPLICATION. To sign, print name below of applicant if over 18, print name of legal guardian if under: *
I am over 18 or am the legal guardian of the applicant *
Required
EXEMPTION FROM LIABILITY AGREEMENT
I, ( NAME OF APPLICANT)  CERTIFY THAT I AM IN GOOD HEALTH AND HAVE NO PHYSICAL DEFECTS WHICH WOULD ENDANGER MY HEALTH IN THE PARTICIPATION AND PRACTICE OF JUDO AT THE DBT JUDO DOJO.

I, THE UNDERSIGNED, FOR MYSELF, SPOUSE, FAMILY, HEIRS, EXECUTORS AND PERSONAL REPRESENTATIVES, EXEMPT AND RELEASE THE DBT JUDO DOJO AND THE TRI-STATE DENVER BUDDHIST TEMPLE, ITS DIRECTORS , OFFICERS, INSTRUCTORS, COMMITTEE MEMBERS , AGENTS, SERVANTS, EMPLOYEES, AND LESSORS FROM ANY AND ALL LIABILITY, CLAIMS, DEMANDS OR ACTIONS OR CAUSES OF ACTION WHATSOEVER, ARISING OUT OF ANY DAMAGE, LOSS OR INJURY TO ME OR MY PROPERTY, WHILE UPON THE PREMISES OF THE TRI-STATE DENVER BUDDHIST TEMPLE, OR WHILE AT ANY ATHLETIC EVENT, WHEREVER LOCATED, SPONSORED BY THE DBT JUDO DOJO OR THE TRI-STATE DENVER BUDDHIST TEMPLE , OR WHILE PARTICIPATING IN ANY OF THE ACTIVITIES CONTEMPLATED BY THIS EXEMPTION FROM LIABILITY AGREEMENT, WHETHER SUCH LOSS, DAMAGE OR INJURY RESULTS FROM THE NEGLIGENCE OF THE DBT JUDO DOJO OR THE TRI-STATE DENVER BUDDHIST TEMPLE , ITS DIRECTORS, OFFICERS, INSTRUCTORS, COMMITTEE MEMBERS, AGENTS, SERVANTS, EMPLOYEES, AND LESSORS OR FROM SOME OTHER CAUSE.

THE UNDERSIGNED RECOGNIZES THAT THE MARTIAL ART OF JUDO IS AVAILABLE THROUGH OTHER ORGANIZATIONS IN THE DENVER METROPOLITAN AREA. THE UNDERSIGNED ALSO RECOGNIZES THAT THE NATURE OF THE ACTIVITIES CONTEMPLATED BY THIS EXEMPTION FROM LIABILITY AGREEMENT MAY SUBJECT ME TO PHYSICAL INJURY OR ILLNESS AND THAT THE DBT JUDO DOJO AND THE TRI-STATE DENVER BUDDHIST TEMPLE DOES NOT HAVE ON STAFF MEDICAL PERSONNEL OR EQUIPMENT TO TREAT INJURIES THAT MAY ARISE.  IN CONSIDERATION OF BEING ACCEPTED AS A GUEST OF THIS DOJO, I AGREE TO ABIDE BY ALL THE APPLICABLE RULES AND REGULATIONS OF THIS ORGANIZATION AND OF THE TRI-STATE DENVER BUDDHIST TEMPLE, DBT JUDO DOJO AND THE USJI WHICH GOVERNS THIS SPORT.
THE UNDERSIGNED UNDERSTANDS AND AGREES TO THE TERMS AND CONDITION SET FORTH IN THE LIABILITY WAIVER. To sign, print name below of applicant if over 18, print name of legal guardian if under: *
I am over 18 or am the legal guardian of the applicant *
Required
EMERGENCY CONTACTS
THE INFORMATION REQUESTED BELOW WILL ASSIST IN OBTAINING QUICK MEDICAL AID SHOULD AN ILLNESS OR INJURY OCCUR WHILE PARTICIPATING IN JUDO.  EVERY EFFORT WILL BE MADE TO CONTACT THE PARENT, GUARDIAN OR SPOUSE LISTED BELOW IF AN EMERGENCY ARISES. HOWEVER, IF THIS PERSON CANNOT BE REACHED, THIS MEDICAL RELEASE IS REQUIRED FOR TREATMENT OR HOSPITALIZATION.
PRIMARY EMERGENCY CONTACT *
CONTACT'S PHONE # *
CONTACT'S EMAIL *
ALTERNATIVE EMERGENCY CONTACT
ALTERNATIVE CONTACT PHONE #
ALTERNATIVE CONTACT EMAIL
Please be prepared to sign a release/waiver and emergency medical form. *
Required
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