AIKIDO OF MINNESOTA !!! AIKIDO-UNIVERSITY OF MINNESOTAAND · aikido of minnesota !!! aikido-university of minnesota and $ 60 saturday + sunday $ 50 saturday only $30 sunday only fall

AIKIDO OF MINNESOTA ! ! ! ANDAIKIDO-UNIVERSITY OF MINNESOTA

$60 SATURDAY + SUNDAY

$50 SATURDAY ONLY

$30 SUNDAY ONLY

FALL 2010 SEMINAR! ! FEATURING: REV. ZENKO N. OKIMURA

! ! 7TH DAN SHIHAN

! ! CHIEF INSTRUCTOR, WORLD AIKIDO AIKIKAI INC.

OCTOBER 16,17• U OF M ARMORYSATURDAY, OCT 16SATURDAY, OCT 16

SUNDAY, OCT 17SUNDAY, OCT 17

9:00 - 9:20 Registration 9:00 - 10:15 Class

9:30 - 10:30 Class10:30 - 12:00 Class

10:45 - 12:00 Class

12:00 - 2:15 Lunch

2:15 - 3:15 Class

3:30Testing

7:00Dinner hosted by Justin Haring (directions on back)

Dinner hosted by Justin Haring (directions on back)

Dinner hosted by Justin Haring (directions on back)

*Please bring your own jo and bokken*Please bring your own jo and bokken*Please bring your own jo and bokken*Please bring your own jo and bokken

For additional information, please contact Patrick Riley 651-308-8219, or visit

our website at umnaikido.wordpress.comFor additional information, please contact Patrick Riley 651-308-8219, or visit



our website at umnaikido.wordpress.com

http://umnaikido.wordpress.com/







Directions

University of Minnesota Armory 15 Church St. SE Minneapolis, MN 55455

Take Interstate 35W north from Interstate 94. Head east on University Ave. The nearest available parking ramps are the Church St. Garage, the 4th St. Ramp, and the Washington Ave. Ramp. For more details go to http://www1.umn.edu/twincities/maps/Armory/

35 W35 W

Registration

Name: _____________________________________ Address: ___________________________________ Phone: _____________________________________ Email: _____________________________________ Dojo: _____________________________________ Rank: _____________________________________ Days attending: Sat. Sun. Both (circle one) Seminar Fees:

Sat/Sun __________ ($60)

Sat Only __________ ($50)

Sun Only __________ ($30)

Donation __________

Total __________ * Registration forms and seminar fees will be collected at the door. Please make checks payable to: University of Minnesota Aikido Club Please send an email to [email protected] if you plan to attend, so that we may plan accordingly and notify you of any changes! For lodging information – hotel or housing with a member, please contact Patrick Riley at 651-308-8219.

Aikido of Minnesota and University of Minnesota General Release

BECAUSE PARTICIPATION IN AIKIDO CLASSES MAY BE DANGEROUS, WE REQUIRE ALL PARTICIPANTS TO ASSUME ALL RISK BY SIGNING THIS GENERAL RELEASE.

The Undersigned, for himself or herself and personal representatives, assigns, heirs and next of kin or any of them:

1. Hereby Releases, Waives, Discharges and Covenants Not To Sue Aikido of Minnesota or University of Minnesota, and each of its instructors or officers, employees and agents all for purpose herein referred to as Releases, from liability to the Undersigned, his personal representatives, assigns, heirs and next of kin for all loss or damage and any claim or demands therefore, on account of injury to the person or property or resulting in death of the Undersigned, whether caused by the negligence of Releases or otherwise while the Undersigned is upon the premises of Aikido of Minnesota or University of Minnesota and/or a participant in classes or workouts, and

2. Hereby Agrees To Indemnify And Save And Hold Harmless the Releases and each of them from any loss, liability, damage, or cost they may incur (1) due to the presence of any action of the Undersigned in or about Aikido of Minnesota or University of Minnesota, and/or (2) due to participation in classes or workouts whether caused by the negligence of the Releases or otherwise.

The Undersigned expressly agrees that the foregoing Release, Waiver and Indemnity Agreement is intended to be as broad and inclusive as is permitted by the Law of the State of Minnesota and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. The Undersigned warrants the following statements are true and correct and understands that the Releases have relied on them in entering into the foregoing Release, Waiver and Indemnity Agreement and in giving the Undersigned permission to enter the premises of the Aikido of Minnesota or University of Minnesota and to participate in aikido classes:

1. No oral representations, statements or inducements apart from this written agreement have been made.

2. The Undersigned individually is fully aware of the risks and hazards inherent in entering upon the premises of Aikido of Minnesota or University of Minnesota or in participating in any events or classes held in or upon the premises of Aikido of Minnesota or University of Minnesota and hereby acts voluntarily to enter upon said premises, knowing the present condition and knowing that said condition may become more hazardous and dangerous during the time that the Undersigned or either of them are upon said premises. The Undersigned is fully aware that martial arts and all activities associated with participation in aikido classes and workouts (which of necessity may include rigorous physical exertion, bodily contact, throws, pins, and takedowns) is a calculated risk activity, and contains inherent risks and dangers (including serious injury or death), that no amount of care, caution, instruction, or expertise can eliminate. The participant knows and understands the scope, nature and extent of the risks involved in the activities contemplated by this agreement. The Undersigned individually hereby voluntarily assumes all risks of loss, damage, or injury that may be sustained while in or upon the premises of Aikido of Minnesota or University of Minnesota or as a participant in aikido classes and workouts.

3. That the Undersigned participant gives consent to whatever medical care might be provided or available on the premises and further agrees to conform and comply with all the rules and regulations of Aikido of Minnesota or University of Minnesota.

4. THE UNDERSIGNED PARTICIPANT OR HIS OR HER LEGAL REPRESENTATIVE OR GUARDIAN HAS READ AND VOLUNTARILY SIGNS THIS RELEASE AND WAIVER OF ALL LIABILITY AND INDEMNITY AGREEMENT.

PARTICIPATION IN AIKIDO CLASSES AND WORKOUTS MAY BE DANGEROUS. BY SIGNING THIS DOCUMENT YOU CERTIFY THAT YOU ARE OVER 18 YEARS OF AGE AND THAT YOU UNDERSTAND ITS CONTENTS. SIGNATURE ________________________________ DATE: __________________ PLEASE PRINT NAME: ________________________________ OR, IF YOU ARE UNDER 18 YEARS OF AGE YOU WILL NEED THE SIGNATURE OF YOUR PARENT OR LEGAL GUARDIAN. PARENT'S OR LEGAL GUARDIAN'S SIGNATURE ____________________________________________

DATE:______________________

Sport Clubs Program 10-11 Page 1 of 4 OGC Approved: 7.23.04 TS

Participation Waiver Club Name _____________________

1901 University Ave. SE Room 110 612.625.6017 [email protected]

Incomplete waivers will not be accepted. All approved waivers will be kept on file in the Sport Clubs Office.

Personal Information First Name M.I. Last Name

Address

City State Zip Sex (Male/Female)

Phone

Email

Student ID #

Date of Birth

University Status (check one) Undergraduate

Graduate Student Faculty/Staff Alumni Other:

Fee Status (check one) Student Fees

URC Membership Affiliate Card Coach Volunteer Coach Paid

Emergency Contact Information Name Phone

Address

Relationship

Health Insurance (check one) I have medical insurance coverage and understand that I must maintain insurance coverage throughout my participation in the sport club activity. Insurance Company: __________________________________

I do not have medical insurance coverage.

Release and Assumption of Risk and Cost In consideration of the opportunity to be a sport club member and participate in sport club activities, I, on behalf of myself, my agents, heirs and next of kin, hereby agree to release, indemnify, and hold harmless Regents of the University of Minnesota, Department of Recreational Sports, the Sport Clubs Program and their respective employees, agents, members and representatives (herein referred to as �“University�”) from any responsibility or liability for personal injury, including death, and damage to or loss of property, whether or not arising from the negligence of the University, that I may incur while I am traveling to or from, engaged in practice or competition, being coached, triaged by trainers, using or operating equipment or otherwise participating in a sport club activity. I verify that I am informed that the sport clubs are coached by individuals, who may be team members or former team members and who either volunteer their services or are employed by the Department of Recreational Sports. In addition, I understand that the University does not provide medical insurance coverage and that I, as a member and participant in the Sport Club Program, must provide personal medical insurance. In the case of injury or medical emergency and in the event participant, or their parent or guardian, cannot respond at the time of the emergency, University has permission to seek, administer, or have administered whatever first aid or emergency medical care deemed necessary for participant�’s welfare, and it is understood that participant, and not University, shall be responsible for any and all charges for such health care services regardless of whether participant�’s medical insurance would cover such charges. Furthermore, I recognize that every sport club activity has a certain degree of risk, and I knowingly and voluntarily assume the risk of any injuries, regardless of severity, including death, and all risk of damage to or loss of property which I may incur, even if arising from the negligence of the University, while I am participating in a sport club activity. I certify that to my knowledge there is no medical reason why I cannot safely participate in sport club activities and I agree to abide by all University policies and applicable University regulations regarding my participation in a sport club activity.

I, the undersigned, am competent to sign this release, and have read carefully, understand, and agree to all its terms. (If participant is under age 18, parent/legal guardian signature)

Signed _____________________________________________________ Date ____________________

Printed Name _________________________________________ Phone________________________

Officer Signature for Submission




Travel Release I understand that as a member of the Sport Clubs Program, University automobile liability insurance coverage is applicable while traveling to and from a Sport Clubs Program function in any University vehicle. I also understand that if I choose to drive my own vehicle or be a passenger in a non-University vehicle while traveling to and/or from a Sport Clubs function, I waive all my rights to University automobile insurance coverage. In addition, I understand that if I choose to be a driver of a University vehicle, I must be 19 years of age, must have a valid, proper, and approved driver�’s license by a U.S. state or Canadian province, and must attend approved Driver�’s Training. I also understand that all passengers in the vehicle must be part of official or authorized University business and that no guests are allowed to travel in a University vehicle. As the driver, I agree to abide by and enforce such rules, as well as all applicable laws and University policies. I further understand that all passengers are required to wear seatbelts at all times while traveling in University vehicles. Furthermore, as the driver of a University vehicle, I recognize that I am responsible for any damage that may occur to the vehicle while it is in my care. I understand that I will be responsible for the payment of any insurance deductible for any damage to the vehicle and any other fines, late fees, penalties or payments assessed by the University, Sport Club Program or any other legal entity. Understanding and accepting the aforementioned information, I on behalf of myself, my agents heirs and next of kin, hereby agree to release and hold harmless the University (as defined above) from any responsibility or liability for personal injury, including death, and damage to or loss of property, that I may incur due to the negligence of the University or my own negligence or due to accidental occurrences while I am traveling to or from my destination.

Sport Club Membership Oath

I wish to become a member of a sport club and to participate in sport club activities at the University. As a member of the Sport Club Program, I pledge to adhere to all of the guidelines, policies and procedures set forth by the governing bodies of the Sport Club Program, including University Institutional Policies, Department of Recreational Sports policies, and National Governing Bodies and the Sport Club Council policies. I verify that I have read, understand and accept the information presented in the Sports Club Handbook while paying specific attention to the following: 1 I understand that I must be at least 18 years of age (or a registered student paying student services fees) to become a member

of a sport club or participate in any sport club sponsored event. 2 I understand that I will be held personally accountable for any expense I approve or incur for personal or unapproved club related

activities. 3 I understand and accept all policies related to vehicle rental including: all drivers must be 19 years of age with a valid driver�’s

license, only current sport club members and their coaches may be transported in any University vehicle, and no guests are allowed to travel in any University vehicle.

4 I understand that all donations, sponsorship negotiations and contracts must be negotiated in conjunction with the Sport Club Office, Sport Club Council and the Department of Recreational Sports. Furthermore, I understand that any and all equipment purchased or donated to the Sport Club Program or an individual sport club remains property of the Department of Recreational Sports and not of the individual sport club or its members.

5 I understand that violation of any policy and/or procedure outlined in the Sport Club Handbook may be grounds for immediate dismissal as a member of the Sport Club Program, and that additional University institutional action may be taken.

6 I understand that I am a member of a Campus Life Program, and as such, I am representing the University during or while traveling to practices, competitions and other special events for club business. Therefore, my behavior will be governed by the Sport Club Handbook, Department of Recreational Sport and Sport Clubs staff policies, other University policies, and the Student Conduct Code.

I, the undersigned, am competent to sign this release, and have read carefully, understand, and agree to all its terms. (If participant is under age 18, parent/legal guardian signature)

Signed _____________________________________________________ Date ____________________


I, as the participant, have read the Sport Club Membership Oath and will abide by the rules, regulations and policies that the University, the Department of Recreational Sports and the Sport Clubs Program have set.

Signed ________________________________________ Date ____________________




Code of Conduct

The Sport Clubs Program aims to provide recreational activities for members of the University community. These activities should be conducted in a manner that represents the best interest of the University, while minimizing risk, ensuring participant safety, and maintaining quality facilities and equipment. Any conduct that interferes with these goals will result in disciplinary action for individuals and/or clubs involved. of Conduct violations can include, but are not limited to, the following:

Access infractions�—Engaging in unauthorized entry and exit from University Facilities.

Allowing unauthorized users to enter the facility. Entering the facility through any door other than the main

entrance. Entering the facility without the proper safety and or

authorized personnel in attendance Unable to produce a valid picture ID when requested. Exiting door marked as emergency exists only. Using facilities as an affiliated member or coach during

times and in spaces other than club practice times and space.

Unauthorized use of any facility on campus while serving as a representative.

Facility/Equipment Issues�—Disregarding equipment or facility polices.

Failure to return checkout equipment or keys in prescribed time.

Destroying or defacing any property. Failure to properly maintain any University equipment or

field space. Failure to cancel practice or competition due to ground

saturation, weather conditions, or other field conditions. Financial Infractions�—Inappropriately using or managing club money.

Unauthorized expenditures Unauthorized accounts Negative account balances

Travel Infractions�—In appropriate behavior while on club/University business.

Inappropriate use of rental vehicles Inappropriate use of hotel/motel rooms Inappropriate travel Consume or in possession of alcohol or illegal drugs

while traveling for club/University business.

Behavior�—Disregarding the Sport Clubs Program policies about drugs, alcohol, and behavior

Consume or in possession of alcohol or illegal drugs while serving as a representative of the club and institution (club travel, practice, meetings, etc).

Strike, or attempt to strike, an opposing player beyond the realm of the sport.

Intentionally engage in or incite participants and/or spectators to engage in abusive or violent behavior �– verbal or physical.

Use obscene gestures, profanity, or disrespectful language. Purposefully insult, disrespect, or threaten any participant,

official, staff, spectator, or other to any extent while representing the University, Department of Recreational Sports, Sport Clubs Program, or the individual club.

Staff/Participant Safety�—Jeopardizing the health and wellbeing of staff and other participants.

Vulgar, obscene, abusive, derogatory, or demeaning comments or gestures.

Threats, intimidation, or verbal aggression. Initiating acts of physical aggression. Fighting (punches thrown). Failure to complete incident or accident report form. Failure to comply with requests from Recreational Sports

Staff. Being under the influence of alcohol/illegal substances.

Facility Policies�—Intentionally disregarding existing facilities policies.

Willful or repeated disregard for Facility Policies. Failure to comply with requests from Recreational Sports

Staff. Being under the influence of alcohol/illegal substances. Using facility space for club purposes when unauthorized or

not scheduled.

I, the undersigned, am competent to sign this code of conduct, and have read carefully, understand, and agree to all its terms. I also understand that I am required to follow the University of Minnesota code of conduct.

(If participant is under age 18, parent/legal guardian signature)

Signed _____________________________________________________ Date ____________________





Academic Eligibility

I have read and understand the University�’s academic requirements for participants in the Sport Clubs Program. I authorize the inspection of my records. I authorize the release of academic information by the Office of the Registrar to the necessary national governing body, league, conference, event, club officers, club coaches, club instructors and to the Sport Clubs Program staff for the purpose of verifying academic eligibility for competition in the Sport Clubs Program and to accumulate summary data regarding the club. FIRST NAME

LAST NAME

EMAIL

PHONE

STUDENT ID

DATE

SIGNATURE Model Release and Authority to Identify

I, the undersigned, hereby grant the University of Minnesota permission to use photographs of me as elements of an assemblage/collage/photographic piece. I also give them permission to put the finished photographs to any legitimate uses they may deem proper. Further, I relinquish and give them all right, title, and interest I may have in the finished pictures, negatives, reproductions, and copies of the original prints and negatives, and grant them the right to give, sell, transfer, and exhibit the negatives, original prints, or copies and facsimiles thereof, to any responsible individual, business firm, or publication, or to any of there assignees.

I, the undersigned, am competent to sign this release, and have read carefully and understand and agree to all its terms. (If participant is under age 18, parent/legal guardian signature)

Signed _____________________________________________________ Date ____________________


I further authorize the University of Minnesota to identify me in connection with the publication of any such photos as specified

below (Please print how you wish to be identified. You may choose to use your full name or for privacy reasons you could use your first name only, first initial and last name, or

general description of student status, such as �“Junior in CLA�”).

Print: ____________________________________________________________________________________________

Members of intercollegiate competitive clubs will have their academic records checked by the Sport Clubs Program at the beginning of each semester or upon the submission of their Participation Waiver. Club members will be deemed �“eligible�” to participate in intercollegiate competition if they meet the following criteria: Within six years of their first term of full-time enrollment, if an undergraduate student; Carry at least a 1.65 cumulative grade point average; Currently enrolled full-time. Undergraduates must be enrolled in a minimum of 13 credits to be considered full-time for Sport Club Program

participation; graduates must be enrolled in a minimum of 6 credits. o The full-time credit requirement is waived if the student is carrying the required course load needed to graduate the semester that

they are being certified for (verification from a college official is required). If a club member does not fulfill these expectations, he/she will not be allowed to participate in intercollegiate competition. Governing bodies, leagues and/or event hosts may have additional academic eligibility requirements that participants must meet before they can participate in their event(s). Club officers must submit these academic eligibility requirements and supporting documents into the Sport Clubs Office as soon as they receive them, but no later that one month prior to the event or due date. The Sport Clubs Program staff will submit these additional academic eligibility check requests to the Registrar on the club�’s behalf.

Documents

AIKIDO OF MINNESOTA !!! AIKIDO-UNIVERSITY OF MINNESOTAAND · aikido of minnesota !!! aikido-university of minnesota and $ 60 saturday + sunday $ 50 saturday only $30 sunday only fall