Drop In Sign-up Form

BILLING:  MONTHLY TUITION AMOUNT will be collected monthly regardless of the use of your membership.  

MEMBERSHIP FREEZE: You may freeze your account for up to ninety (90) days at a time no more than 2 times in a 12 (twelve) month period. To do so, you must fill out a membership freeze form and submit it to Kingsway thirty (30) days prior to the date you wish to begin the membership freeze. Any delinquent payments or fees must be paid prior to membership freeze. During the period in which your account is approved for membership freeze, your credit card on file will be billed $10 for each month, on the date agreed upon in this Agreement, in place of the full tuition amount until the freeze period ends.

MEMBERSHIP CANCELLATION:
1.) YOU HAVE THE RIGHT TO CANCEL YOUR MEMBERSHIP AT ANY TIME, FOR ANY REASON WITH A FEE EQUAL TO THIRTY (30) DAYS OF YOUR TUITION. Your cancellation request must be made with a cancellation form received and acknowledged by Kingsway. Your membership cancellation will not be processed until cancellation fee amount is collected in full AND Kingsway has received and confirmed your cancellation form. Unless these two items have been received your account will continue to be billed monthly. These cancellation requirements do not apply if the member cancels according to Sections 2, 3, or 4 from the Texas Health Spa Act, which are disclosed above.  

2.) YOU HAVE THE RIGHT TO CANCEL YOUR MEMBERSHIP IMMEDIATELY AND WITHOUT PENALTY if you have a change of physical address, being that your new address is more than 20 miles from this school and there are no other Kingsway schools in a 20 (twenty) mile radius of the new address (requires proper documented proof: Utility Bill, Mortgage/Rent Receipt etc.)  

ALL DELINQUENT PAYMENTS AND FEES MUST BE PAID PRIOR TO A MEMBERSHIP FREEZE OR CANCELLATION BEFORE THEY CAN BE APPROVED, unless your membership is cancelled according to Sections 2, 3, and 4 of the Texas Health Spa Act disclosed above.

By: ((signature_area))

RELEASE & WAIVER OF LIABILITY & INDEMNITY AGREEMENT AND MEDIA RELEASE (the “RELEASE”)

PLEASE READ CAREFULLY AND COMPLETELY BEFORE SIGNING.

As used in herein:

“Martial Arts Program” means the attendance and membership at the Gym including participation in Gym activities, such as attending classes, weight training and conducting other exercises, competitions and other similar activities.

“Gym” means the gym located at KINGSWAY JIU JITSU, 13776 N HWY 183, UNIT 122, Austin TX.

“Company” means Kingsway and/or Koryu LLC.

IN CONSIDERATION OF BEING PERMITTED TO PARTICIPATE IN ANY WAY IN THE MARTIAL ARTS ACTIVITIES AND EVENTS AT THE GYM OR WITH KINGSWAY AND/OR THE COMPANY, THE STUDENT AND/OR THE PARENT(S) AND/OR LEGAL GUARDIAN(S) OF THE MINOR STUDENT AGREE THAT:    

1.) THE STUDENT(18+ years old) AND/OR THE PARENT(S) AND/OR LEGAL GUARDIAN(S) WILL INSTRUCT THE STUDENT THAT, PRIOR TO PARTICIPATING IN THE MARTIAL ARTS ACTIVITY OR EVENT, HE OR SHE HAS THE RIGHT TO INSPECT THE FACILITIES AND EQUIPMENT TO BE USED.  I UNDERSTAND AND AGREE THAT, IF AT ANY TIME, I FEEL ANYTHING TO BE UNSAFE, I WILL IMMEDIATELY TAKE ALL PRECAUTIONS TO AVOID THE UNSAFE AREA AND REFUSE TO PARTICIPATE FURTHER.

2.) I/WE ARE AWARE AND UNDERSTAND THAT PARTICIPATING IN THE MARTIAL ARTS PROGRAM AND ATTENDING THE GYM IS A POTENTIALLY DANGEROUS ACTIVITY AND INVOLVES THE RISK OF PERSONAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, TEMPORARY OR PERMANENT DISABILITY, DEATH, PROPERTY DAMAGE, FINANCIAL LOSS, AND/OR OTHER SOCIAL AND ECONOMIC LOSS. I/WE ARE ALSO AWARE OF THE CONTAGIOUS NATURE OF BACTERIAL AND VIRAL DISEASES, INCLUDING COVID-19 (COLLECTIVELY, THE “DISEASE”) AND THE RISK THAT I/WE MAY BE EXPOSED TO OR CONTRACT THE DISEASE BY BEING AT THE GYM AND ENGAGING IN THE MARTIAL ARTS PROGRAM, WHICH MAY RESULT IN ILLNESS, PERSONAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, TEMPORARY OR PERMANENT DISABILITY, DEATH, PROPERTY DAMAGE, FINANCIAL LOSS, AND/OR OTHER SOCIAL AND ECONOMIC LOSS. I/WE ACKNOWLEDGE THAT THESE RISKS MAY RESULT FROM OR BE COMPOUNDED BY THE ACTIONS, OMISSIONS, OR NEGLIGENCE OF THE COMPANY, OR ITS EMPLOYEES OR OTHERS, INCLUDING NEGLIGENT EMERGENCY RESPONSE OR RESCUE OPERATIONS OF THE COMPANY. I/WE UNDERSTAND THAT THE COMPANY CANNOT GUARANTEE THAT I/WE WILL NOT BE INJURED OR BECOME INFECTED WITH THE DISEASE OR OTHER INFECTIOUS DISEASES WHILE AT THE GYM OR DURING MY PARTICIPATION IN THE MARTIAL ARTS PROGRAM AND THAT BEING AT THE GYM AND ENGAGING IN THE MARTIAL ARTS PROGRAM MAY INCREASE MY RISK OF INJURY OR CONTRACTING THE DISEASE. I/WE ACKNOWLEDGE THAT THERE MAY BE OTHER RISKS NOT KNOWN TO US OR ARE NOT REASONABLY FORESEEABLE AT THIS TIME.  NOTWITHSTANDING THESE RISKS, I/WE ACKNOWLEDGE THAT I/WE ARE VOLUNTARILY ACCESSING THE GYM AND PARTICIPATING IN THE MARTIAL ARTS PROGRAM WITH KNOWLEDGE OF THE DANGERS INVOLVED. I/WE HEREBY AGREE TO ACCEPT AND ASSUME ALL RISKS OF ILLNESS, PERSONAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, TEMPORARY OR PERMANENT DISABILITY, DEATH, PROPERTY DAMAGE, FINANCIAL LOSS, AND/OR ANY OTHER SOCIAL OR ECONOMIC LOSS ARISING THEREFROM, WHETHER CAUSED BY THE ORDINARY NEGLIGENCE OF THE COMPANY OR OTHERWISE. 

3.) I/WE HEREBY EXPRESSLY WAIVE AND RELEASE ANY AND ALL CLAIMS, NOW KNOWN OR HEREAFTER KNOWN, AGAINST THE MARTIAL ARTS FACILITY USED BY THE PARTICIPANT, THE OWNERS, MANAGERS AND LESSEES OF THE PREMISES USED TO CONDUCT THE MARTIAL ARTS EVENTS AND PROGRAMS, THE COMPANY AND ITS OFFICERS, DIRECTORS, MANAGER(S), EMPLOYEES, TEACHERS, COACHES, AGENTS, AFFILIATES, SHAREHOLDERS/MEMBERS, SUCCESSORS, AND ASSIGNS (COLLECTIVELY, “RELEASEES”) FROM ALL LIABILITY, INCLUDING BUT NOT LIMITED TO ON ACCOUNT OF PERSONAL OR PSYCHOLOGICAL INJURY, ILLNESS, PAIN, SUFFERING, TEMPORARY OR PERMANENT DISABILITY, DEATH, PROPERTY DAMAGE, FINANCIAL LOSS AND/OR OTHER SOCIAL AND ECONOMIC LOSS ARISING OUT OF OR ATTRIBUTABLE TO MY BEING AT THE GYM OR PARTICIPATING IN THE MARTIAL ARTS PROGRAM, WHETHER ARISING OUT OF THE ORDINARY NEGLIGENCE OF THE COMPANY OR ANY RELEASEES OR OTHERWISE. I/WE COVENANT NOT TO MAKE OR BRING ANY SUCH CLAIM AGAINST THE COMPANY OR ANY OTHER RELEASEE, AND FOREVER RELEASE AND DISCHARGE THE COMPANY AND ALL OTHER RELEASEES FROM LIABILITY UNDER SUCH CLAIMS. 

4.) I/WE CONFIRM THAT I/WE ARE: (A) IN GOOD HEALTH AND PROPER PHYSICAL CONDITION AND DO NOT HAVE ANY MEDICAL OR OTHER CONDITIONS THAT WOULD IMPAIR MY/OUR ABILITY TO PARTICIPATE IN THE MARTIAL ARTS PROGRAM; AND (B) PRIOR TO ATTENDING THE GYM, NOT EXPERIENCING SYMPTOMS OF DISEASE (SUCH AS COUGH, SHORTNESS OF BREATH, SORE THROAT, CONGESTION, HEADACHE, MUSCLE OR BODY ACHES, CHILLS, OR FEVER), AND DO NOT HAVE A CONFIRMED OR SUSPECTED CASE OF THE DISEASE. I/WE WILL COMPLY WITH ALL FEDERAL, STATE, AND LOCAL LAWS, ORDERS, DIRECTIVES, AND GUIDELINES RELATED TO THE MARTIAL ARTS PROGRAM WHILE ATTENDING THE GYM OR PARTICIPATING IN THE MARTIAL ARTS PROGRAM. I/WE WILL ALSO FOLLOW ALL INSTRUCTIONS, RECOMMENDATIONS, AND CAUTIONS OF THE COMPANY AT ALL TIMES. IF AT ANY TIME I/WE BELIEVE CONDITIONS TO BE UNSAFE, THAT I/WE ARE NO LONGER IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN THE MARTIAL ARTS PROGRAM, OR I/WE BEGIN EXPERIENCING SYMPTOMS OF DISEASE, I/WE WILL IMMEDIATELY DISCONTINUE FURTHER PARTICIPATION IN THE MARTIAL ARTS PROGRAM. I/WE ACKNOWLEDGE THAT THE COMPANY IS RELYING ON THESE STATEMENTS TO ALLOW PARTICIPATION IN THE MARTIAL ARTS PROGRAM.

5.) I SHALL DEFEND, INDEMNIFY, AND HOLD HARMLESS THE COMPANY AND ALL OTHER RELEASEES AGAINST ANY AND ALL LOSSES, DAMAGES, LIABILITIES, DEFICIENCIES, CLAIMS, ACTIONS, JUDGMENTS, SETTLEMENTS, INTEREST, AWARDS, PENALTIES, FINES, COSTS, OR EXPENSES OF WHATEVER KIND, INCLUDING REASONABLE ATTORNEYS’ FEES, FEES, AND THE COSTS OF ENFORCING ANY RIGHT TO INDEMNIFICATION UNDER THIS RELEASE AND OF PURSUING ANY INSURANCE PROVIDERS, INCURRED BY THE COMPANY OR ANY OTHER RELEASEES, ARISING OUT OF OR RESULTING FROM ANY CLAIM OF A THIRD PARTY RELATED TO MY (OR MY CHILD’S) BEING AT THE GYM OR PARTICIPATING IN THE MARTIAL ARTS PROGRAM, INCLUDING BUT NOT LIMITED TO ANY CLAIM RELATED TO MY OWN NEGLIGENCE OR THE ORDINARY NEGLIGENCE OF THE COMPANY. 

6.) I HEREBY CONSENT TO RECEIVE MEDICAL TREATMENT DEEMED NECESSARY IF I/WE ARE INJURED OR REQUIRE MEDICAL ATTENTION DURING MY PARTICIPATION IN THE MARTIAL ARTS PROGRAM. I/WE UNDERSTAND AND AGREE THAT I AM SOLELY RESPONSIBLE FOR ALL COSTS RELATED TO SUCH MEDICAL TREATMENT AND ANY RELATED MEDICAL TRANSPORTATION AND/OR EVACUATION. I HEREBY RELEASE, FOREVER DISCHARGE, AND HOLD HARMLESS THE COMPANY AND ALL OTHER RELEASEES FROM ANY CLAIM BASED ON SUCH TREATMENT OR OTHER MEDICAL SERVICES.

7.) EACH OF THE UNDERSIGNED FURTHER 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 TEXAS OR THE STATE IN WHICH THE EVENT IS CONDUCTED AND THAT IF ANY PORTION IS HELD INVALID, IT IS AGREED THAT THE BALANCE SHALL, NOT WITHSTANDING, CONTINUE IN FULL LEGAL FORCE AND EFFECT.

8.) ON BEHALF OF THE PARTICIPANT AND INDIVIDUALLY, THE UNDERSIGNED PARTICIPANT(S) AND/OR LEGAL GUARDIANS FOR THE MINOR PARTICIPANT EXECUTES THIS WAIVER.  IF, DESPITE THIS RELEASE, THE PARTICIPANT MAKES A CLAIM AGAINST COMPANY OR ANY OF ITS’ OWNERS, MANAGERS, EMPLOYEES, STAFF, REPRESENTATIVES OR OTHER RELEASEES, THE PARENT(S) AND/OR LEGAL GUARDIAN(S) WILL REIMBURSE COMPANY FOR ANY MONEY WHICH THEY HAVE PAID TO THE PARTICIPANT, OR ON HIS BEHALF, AND HOLD THEM HARMLESS. 

9.) I HEREBY ACKNOWLEDGE AND UNDERSTAND THAT MARTIAL ARTS ARE PHYSICAL ACTIVITIES AND LEARNING SELF-DEFENSE SKILLS INVOLVES SOME PHYSICAL CONTACT.  NEITHER COMPANY NOR ITS’ OWNERS, MANAGERS, EMPLOYEES, STAFF OR REPRESENTATIVES ARE NOT TO BE HELD LIABLE OR RESPONSIBLE FOR ANY RISKS AND/OR INJURIES AS A RESULT OF TRAINING MARTIAL ARTS.  THE STUDENT AND/OR LEGAL GUARDIAN OF THE MINOR CONSENTS TO THE STUDENT PARTICIPATING IN THE CLASSES AND TRAINING AND ARE AWARE OF THE RISKS INVOLVED IN SUCH USE.

10.) I/WE AGREE TO COMPLY WITH ALL RULES AND REGULATIONS PROMULGATED BY THE GYM AND THE COMPANY.  IF I HAVE ANY QUESTIONS OR OBSERVE ANY UNUSUAL OR UNNECESSARY HAZARD DURING MY PARTICIPATION, I WILL IMMEDIATELY BRING SUCH TO THE ATTENTION OF THE NEAREST COMPANY EMPLOYEE.  I AGREE TO READ AND ABIDE BY ALL RULES POSTED OR OTHERWISE COMMUNICATED TO ME.  I AGREE TO COMPLY WITH THE REQUESTS AND INSTRUCTIONS OF ALL COMPANY PERSONNEL.  I EXPRESSLY ACKNOWLEDGE AND AGREE THAT I WILL NOT, AND WILL CAUSE MY CHILDREN NOT TO, USE THE “WEIGHT STATION” OR OTHER EXERCISE/WEIGHT TRAINING EQUIPMENT AT THE GYM UNLESS EXPRESSLY APPROVED BY COMPANY AND THE EXECUTION OF AN ADDITIONAL SIGNED WAIVER.

11.) THIS RELEASE CONSTITUTES THE SOLE AND ENTIRE AGREEMENT OF THE COMPANY AND ME WITH RESPECT TO THE SUBJECT MATTER CONTAINED HEREIN AND SUPERSEDES ALL PRIOR AND CONTEMPORANEOUS UNDERSTANDINGS, AGREEMENTS, REPRESENTATIONS, AND WARRANTIES, BOTH WRITTEN AND ORAL, WITH RESPECT TO SUCH SUBJECT MATTER. IF ANY TERM OR PROVISION OF THIS RELEASE IS INVALID, ILLEGAL, OR UNENFORCEABLE IN ANY JURISDICTION, SUCH INVALIDITY, ILLEGALITY, OR UNENFORCEABILITY SHALL NOT AFFECT ANY OTHER TERM OR PROVISION OF THIS RELEASE OR INVALIDATE OR RENDER UNENFORCEABLE SUCH TERM OR PROVISION IN ANY OTHER JURISDICTION. THIS RELEASE IS BINDING ON AND SHALL INURE TO THE BENEFIT OF THE COMPANY AND ME AND OUR RESPECTIVE HEIRS, SUCCESSORS, AND ASSIGNS. ALL MATTERS ARISING OUT OF OR RELATING TO THIS RELEASE SHALL BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE INTERNAL LAWS OF THE STATE OF TEXAS WITHOUT GIVING EFFECT TO ANY CHOICE OR CONFLICT OF LAW PROVISION OR RULE (WHETHER OF THE STATE OF TEXAS OR ANY OTHER JURISDICTION). ANY CLAIM OR CAUSE OF ACTION ARISING UNDER THIS RELEASE MAY BE BROUGHT ONLY IN THE FEDERAL AND STATE COURTS LOCATED IN TEXAS AND I HEREBY CONSENT TO THE EXCLUSIVE JURISDICTION OF SUCH COURTS.

I HAVE READ THIS RELEASE, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

MEDIA RELEASE

1. I/WE further agree that, by signing, and/or by my child participating in any activity held at the Gym or organized by Company, I authorize and irrevocably grant the Company the right to use and depict my (and/or my child’s) likeness, image, name, signature, voice, persona, appearance, title, interviews, testimonials, performance, recordings, statements attributed to me (or my child), biographical information, and other indicia of his or her identity or right of publicity (collectively “Images”) in marketing current and/or future events related to the Gym, the Martial Arts Program or Company, including advertising, programming, and publicity materials in connection with the Gym, Martial Arts Program or Company throughout the world, in any and all media (including but not limited to Facebook, Instagram and other web related sources), now known or hereafter devised, in perpetuity. I/WE agree that such Images may also be used by Company for the aforementioned purpose without compensation to me or my child and without any expiration date.  Furthermore, I/WE hereby irrevocably grant and assign to Company, and its assigned representatives (including social media personalities) without limitation, my individual television, radio, motion picture, photographic, electronic, “Interactive Applications” (as defined below) and all other media rights with respect to my participation in any activity held at the Gym, related to the Martial Arts Program, or organized by Company, or any portion thereof throughout the world, in any and all media, now known or hereafter devised, in perpetuity without compensation. "Interactive Applications" shall mean the presentation in any medium in a way that permits the viewer to interact with or manipulate the presentation or access other relevant information during the presentation. I/WE state that I/WE have no conflicts of interest with the subject matter herein and that I/WE enter into this agreement of my own free will.

2. I/WE agree to refrain from any action which may interfere with ownership of the rights hereunder granted to Company or with any authorized use thereof. 

By:

ARBITRATION, GOVERNING LAW AND VENUE

Arbitration Procedures and Location: You agree to submit any and all disputes to binding arbitration pursuant to the Federal Arbitration Act (Title 9 of the United States Code), which will govern the interpretation and enforcement of this arbitration agreement (“Arbitration Agreement”). Arbitration will be before either (1) JAMS (formerly known as Judicial Arbitration and Mediation Services), http://www.jamsadr.com, or (2) the American Arbitration Association (“AAA”), http://www.adr.org.  The Party initiating arbitration may choose between these two arbitration forums.  If you or Company initiate arbitration, you and we have a choice of doing so before JAMS or the AAA: (1) For arbitration before JAMS, the JAMS Comprehensive Arbitration Rules & Procedures and the JAMS Recommended Arbitration Discovery Protocols for Domestic, Commercial Cases will apply. The JAMS rules are available at http://www.jamsadr.com. (2) Which particular rules apply in AAA arbitration will depend on how much money is at issue. For less than $75,000, the AAA’s Supplementary Procedures for Consumer-Related Disputes will apply; for Disputes involving $75,000 or more, the AAA’s Commercial Arbitration Rules will apply. The AAA rules are available at http://www.adr.org. 

THE COMPANY AND I AGREE TO BRING ANY CLAIM ON AN INDIVIDUAL BASIS AND NOT ON A CLASS AND/OR COLLECTIVE ACTION AND/OR CONSOLIDATED BASIS. ACCORDINGLY:

1. 1. THERE WILL BE NO RIGHT OR AUTHORITY FOR ANY DISPUTE TO BE BROUGHT, HEARD OR ARBITRATED AS A CLASS ACTION AND THE ARBITRATOR WILL HAVE NO AUTHORITY TO HEAR OR PRESIDE OVER ANY SUCH CLAIM (“CLASS ACTION WAIVER”).  THE CLASS ACTION WAIVER SHALL BE SEVERABLE FROM THIS AGREEMENT IF THERE IS A FINAL JUDICIAL DETERMINATION THAT THE CLASS ACTION WAIVER IS INVALID, UNENFORCEABLE, UNCONSCIONABLE, VOID OR VOIDABLE. IN SUCH INSTANCES, THE CLASS ACTION MUST BE LITIGATED IN A CIVIL COURT OF COMPETENT JURISDICTION—NOT IN ARBITRATION.

1. 2. THERE WILL BE NO RIGHT OR AUTHORITY FOR ANY DISPUTE TO BE BROUGHT, HEARD OR ARBITRATED AS A COLLECTIVE ACTION AND THE ARBITRATOR WILL HAVE NO AUTHORITY TO HEAR OR PRESIDE OVER ANY SUCH CLAIM (“COLLECTIVE ACTION WAIVER”).  THE COLLECTIVE ACTION WAIVER SHALL BE SEVERABLE FROM THIS AGREEMENT IF THERE IS A FINAL JUDICIAL DETERMINATION THAT THE COLLECTIVE ACTION WAIVER IS INVALID, UNENFORCEABLE, UNCONSCIONABLE, VOID OR VOIDABLE. IN SUCH INSTANCES, THE COLLECTIVE ACTION MUST BE LITIGATED IN A CIVIL COURT OF COMPETENT JURISDICTION—NOT IN ARBITRATION.

1. 3. REGARDLESS OF ANYTHING ELSE IN THIS AGREEMENT AND/OR THE APPLICABLE ARBITRATION RULES, OR ANY AMENDMENTS AND/OR MODIFICATIONS TO THOSE RULES, ANY CLAIM THAT ALL OR PART OF THE CLASS ACTION WAIVER AND/OR COLLECTIVE ACTION WAIVER IS INVALID, UNENFORCEABLE, UNCONSCIONABLE, VOID OR VOIDABLE, MUST BE DETERMINED ONLY BY A COURT OF COMPETENT JURISDICTION AND NOT BY AN ARBITRATOR.

I ACKNOWLEDGE AND AGREE THAT I AM EXECUTING THIS AGREEMENT VOLUNTARILY AND WITHOUT ANY DURESS OR UNDUE INFLUENCE BY THE COMPANY OR ANYONE ELSE. I FURTHER ACKNOWLEDGE AND AGREE THAT I HAVE CAREFULLY READ THIS AGREEMENT AND THAT I HAVE ASKED ANY QUESTIONS NEEDED FOR ME TO UNDERSTAND THE TERMS, CONSEQUENCES, AND BINDING EFFECT OF THIS AGREEMENT AND FULLY UNDERSTAND IT, INCLUDING THAT I AM WAIVING MY RIGHT TO A JURY TRIAL. FINALLY, I AGREE THAT I HAVE BEEN PROVIDED AN OPPORTUNITY TO SEEK THE ADVICE OF AN ATTORNEY OF MY CHOICE BEFORE SIGNING THIS AGREEMENT.

STUDENT AND/OR RESPONSIBLE PARTY AND COMPANY AGREE THAT, EXCEPT AS PROVIDED HEREIN, ANY AND ALL DISPUTES WHICH ARISE AFTER YOU ENTER INTO THIS AGREEMENT WILL BE RESOLVED EXCLUSIVELY AND FINALLY BY BINDING ARBITRATION RATHER THAN IN COURT BY A JUDGE OR JURY, AND BOTH PARTIES IRREVOCABLY CONSENT TO THE JURISDICTION AND WAIVE ALL OBJECTION THERETO.  THIS AGREEMENT WILL BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF TEXAS, WITHOUT REFERENCE TO ITS CONFLICTS OF LAWS PRINCIPLES.

By:

I hereby purchase a membership at Kingsway, independently owned/ operated by Company. By signing this agreement, I acknowledge receipt of a fully completed copy of this agreement executed by both Kingsway and myself and acknowledge and agree to the terms in this Agreement.

STUDENT/ RESPONSIBLE PARTY SIGNATURE:

By: