ASSUMPTION OF RISK, RELEASE, AND MEDICAL AUTHORIZATION

In consideration of my child being allowed to attend Parents Night Out at Ko Martial Arts LLC ("KOMA") and take part in its activities, I, the undersigned parent or legal guardian, agree to the following on behalf of myself, my child, and our heirs and next of kin:

1. Nature of the activities. I understand that Parents Night Out includes physical activity such as martial arts games, drills, running, jumping, and play with other children. These activities can result in injuries such as bumps, bruises, sprains, and strains, and on rare occasions more serious injuries such as broken bones, torn ligaments, concussion, permanent disability, or death.

2. Sources of risk. I understand these risks may come from my child's own actions, the actions or inaction of other children or staff, the condition of the premises or equipment, or causes that are not known or reasonably foreseeable today.

3. Following instructions. My child agrees to follow the directions of KOMA staff. KOMA staff will supervise all activities, and my child may sit out of any activity at any time.

4. Health of my child. I certify that my child is in good health and has no condition, other than those I have listed on this form, that would prevent safe participation in physical activity.

5. Assumption of risk. Knowing these risks, I voluntarily allow my child to participate and assume all risks of injury to my child.

6. Release. I release, waive, discharge, and agree not to sue Ko Martial Arts LLC, its owners, officers, employees, instructors, volunteers, and agents, and the owners and lessors of the premises (together, the "Released Parties"), for any and all claims, demands, losses, or damages arising from my child's participation, including injury, death, or damage to property, INCLUDING CLAIMS CAUSED IN WHOLE OR IN PART BY THE ORDINARY NEGLIGENCE OF THE RELEASED PARTIES. This release does not apply to gross negligence or intentional misconduct.

7. Indemnification. I agree to indemnify and hold harmless the Released Parties from any claim brought by or on behalf of my child arising from my child's participation.

8. Medical authorization. If my child is injured or becomes ill and I cannot be reached, I authorize KOMA staff to obtain emergency medical care, including calling 911 and allowing a physician, nurse, athletic trainer, or emergency medical personnel to provide treatment. I agree to be responsible for any resulting medical costs.

9. Governing law. This agreement is governed by the laws of the State of Kansas. If any part of it is found unenforceable, the rest remains in full effect.

By checking this box, I confirm that I am the parent or legal guardian of the child named on this form, that I have read and understand this agreement, and that I am signing voluntarily.