Air Capital Judo Waiver, Release of Liability, Concussion Protocol, and Media Consent
General Acknowledgment and Release of Liability
I understand that judo is a contact martial art that involves throws, takedowns, pins, joint locks, falls, and other physical activities. I acknowledge that participation in judo training, classes, practices, open mats, demonstrations, events, and related activities at Air Capital Judo (located at 1050 S Oliver, Wichita, KS 67218) involves inherent risks of injury. These risks may include, but are not limited to, bruises, sprains, strains, fractures, concussions, dislocations, cuts, and—in rare cases—serious, permanent, or catastrophic injury, including death.
By enrolling myself or my minor child at Air Capital Judo, I certify that I (or my child) am physically fit to participate and have no known medical condition that would prevent safe participation in judo training. I voluntarily assume all risks associated with participation.
I hereby release, waive, discharge, and hold harmless Air Capital Judo, its owners, instructors, Senseis, coaches, staff, volunteers, agents, and affiliates from any and all claims, demands, actions, or causes of action for injury, loss, damage to person or property, or death arising out of or related to participation in these activities, except to the extent caused by gross negligence or intentional misconduct where such limitation is not permitted by law.
I understand that it is my responsibility to follow all safety instructions provided by instructors, to promptly inform instructors of any injuries, medical conditions, or limitations, and to ensure that my (or my child’s) behavior contributes to a safe and respectful training environment.
Concussion Awareness and Protocol
Summary and Acknowledgment
Judo training carries a risk of head impacts that can result in a concussion—a serious brain injury that alters normal brain function. All concussions are significant, even if mild or without loss of consciousness. Continuing to train with symptoms can worsen the injury, delay recovery, or—in rare cases—lead to severe complications or death.
Air Capital Judo prioritizes safety and follows protocols for recognizing and managing suspected concussions. Any participant suspected of sustaining a concussion will be immediately removed from training and may not return until cleared by a qualified healthcare provider. Participants and parents/guardians must understand concussion signs/symptoms, report concerns immediately, and comply with return-to-training requirements.
By signing below, I acknowledge that I have read and understand the full Concussion Protocol below, the risks of concussion in judo, the importance of early recognition and response, and the club's removal and medical clearance procedures. I agree to report any suspected symptoms promptly and follow medical guidance for safe return.
What Is a Concussion?
A concussion is a type of brain injury that alters the way the brain normally functions. It may be caused by a bump, blow, or jolt to the head, or by a fall or blow to the body causing rapid back-and-forth movement of the head and brain. Even seemingly mild impacts can be serious.
Important Facts About Concussions:
1. All concussions are serious.
2. Most occur without loss of consciousness.
3. Early recognition and proper response can help prevent further injury or, in rare cases, death.
Removal From Training
If a Sensei, coach, or staff member determines a participant may have sustained a concussion, they will be immediately removed from training for the remainder of the day (or longer, depending on severity). Return to training requires written medical clearance from a licensed healthcare provider experienced in concussion management.
Signs and Symptoms of a Concussion
Physical Symptoms
- Headache or pressure in the head
- Nausea or vomiting
- Balance problems or dizziness
- Fatigue or feeling unusually tired
- Blurred or double vision
- Sensitivity to light or noise
- Numbness or tingling
- Feeling “not right” or “off”
- Head shaking
Observable or Cognitive Signs
- Appears dazed or stunned
- Confusion about events
- Slow response to questions
- Repeating questions
- Difficulty recalling events before or after the impact
- Loss of consciousness (even briefly)
- Behavior or personality changes
- Forgetting class schedules or assignments
Emergency Symptoms – Seek Immediate Medical Care
Seek emergency attention immediately if any of the following occur:
- One pupil larger than the other
- Drowsiness or inability to be awakened
- Headache that worsens or does not go away
- Weakness, numbness, or decreased coordination
- Repeated vomiting or persistent nausea
- Convulsions or seizures
- Difficulty recognizing people or places
- Increasing confusion, restlessness, or agitation
- Unusual or erratic behavior
- Loss of consciousness (even briefly)
Photo/Video Consent
I understand that photos, videos, and other media may be taken during classes, practices, open mats, demonstrations, and events at Air Capital Judo for purposes of promotion, documentation, and sharing dojo activities.
I grant Air Capital Judo permission to use my (or my child’s) image, likeness, voice, and/or appearance in photographs, videos, recordings, or other media in print materials, on the website (capitaljudoair.com), social media, or other digital platforms, without compensation or further notice.
If I wish to withdraw or limit this consent at any time, I will notify Air Capital Judo in writing (e.g., via email to aircapwic@gmail.com), and the dojo will make reasonable efforts to cease future use of new media featuring me/my child. Previously published or distributed media is not affected by withdrawal.
Overall Acknowledgment and Signature
My signature below confirms that I have read, understood, and agree to all sections of this Waiver, Release of Liability, Concussion Protocol, and Media Consent. This agreement applies to me (if 18+) or my minor child and remains in effect for the duration of participation at Air Capital Judo. Electronic signatures are valid and binding.
sent, I agree to notify Air Capital Judo in writing.”