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Waiver
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– Waiver
First Name
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Last Name
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Address
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Email
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Date of Birth
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Do you have any Medical Conditions?
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1. The activities, classes and workshops provided by KOM King of the Mats Jiu-Jitsu involve risks and dangers of serious health related issues, serious bodily injury, including permanent disability, paralysis and death (the “risks”). There may be other risks either not known to me or not readily foreseeable at this time (the unknown risks”) and I ACCEPT AND ASSUME THE RISKS AND THE UNKNOWN RISKS AND ALL RESPONSIBILITIES FOR ANY LOSSES, COSTS, AND DAMAGES WHATSOEVER that I may suffer and/or incur as a result of attending/participating in any of the KOM King of the Mats Jiu-Jitsu classes, trainings and workshops.
2. That even with clear instructions, there remains possibility of injury and that is my responsibility to consult a physician regarding my ability to participate before coming to KOM King of the Mats Jiu-Jitsu
3. I attest that I have no physical, psychological, medical or emotional condition that would prevent me from safe participation in any of the KOM King of the Mats Jiu-Jitsu.
4. I, and my legal representatives, successors and assigns, HEREBY RELEASE AND DISCHARGE KOM King of the Mats Jiu-Jitsu. and its administrators, directors, officers, volunteers, instructors, employees and staff, of and from all liabilities, claims, causes of action, losses, and damages in anyway whatsoever arising from or related to my attending/participating in any KOM King of the Mats Jiu-Jitsu classes, trainings or workshops, including but not limited to any claims caused or alleged to be caused in whole or in part by the negligence of KOM King of the Mats Jiu-Jitsu
5. I, and my legal representatives, successors and assigns, HEREBY RELEASE AND DISCHARGE KOM King of the Mats Jiu-Jitsu and its administrators, directors, officers, volunteers, instructors, employees and staff, of and from all liabilities, claims, causes of action, losses, and damages in anyway whatsoever arising from or related to the loss, theft or damage of any of my personal property from the KOM King of the Mats Jiu-Jitsu premises.
6. I recognize that this agreement of release and waiver of liability is a legally binding agreement and that I understand all the terms provided in this Agreement.
7. I further acknowledge and understand that by signing this agreement, I completely forego all my legal rights to make any claims against KOM King of the Mats Jiu-Jitsu
8. I further agree in the event that I commence any such claim, action or proceeding, this Agreement may be pleaded by KOM King of the Mats Jiu-Jitsu and its administrators, directors, officers, volunteers, instructors, employees and staff, and by the person, firm or corporation who might have a claim for contribution or indemnity from KOM King of the Mats Jiu-Jitsu as a complete bar and defense to such claim or action, and I agree to indemnify and hold harmless KOM King of the Mats Jiu-Jitsu from any and all claims, causes of action, resulting losses and damages and all expenses and legal fees incurred in responding to the commencement of such claim or action.
9. I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, AND UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT. I HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT, ASSURANCE OR UNDUE INFLUENCE OF ANY KIND. I INTEND IT TO BE A COMPLETE AND UNCONDITIONAL ASSUMPTION OF THE RISKS OF THE ACTIVITIES AND A WAIVER AND RELEASE OF THE LIABILITIES OF THE RELEASEES (KOM King of the Mats Jiu-Jitsu) I AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THAT THE BALANCE IS SEVERABLE AND SHALL CONTINUE IN FULL FORCE AND EFFECT.
10. By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.
11. I grant King of the mats jiu jitsu permission to take photographs and or videos of me (and or my child) during classes, events, or activities. I understand that these images may be used for promotional purposes, including but not limited to social media, websites, advertisements, and printed materials and acknowledge for the use of images I will not receive any compensation.
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