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PLEASE SIGN BELOW OR DOWNLOAD AND SIGN THE FORM ABOVE TO PARTICIPATE
ASSUMPTION AND ACKNOWLEDGMENT OF RISKS RELEASE OF LIABILITY AND INDEMNITY AGREEMENT
I hereby represent that, for myself and any minor children for whom I am parent, the student is physically fit to take the prescribed martial arts course of instruction and that I have had the opportunity to observe and participate in the art of self-defense prior to signing this agreement. In consideration of being allowed to participate in martial arts training and activities, for myself and any minor children for whom I am parent, legal guardian or otherwise responsible, and for my/our heirs, personal representatives or assigns;
1.) ACKNOWLEDGMENT OF RISKS. I acknowledge that MARTIAL ARTS ACTIVITIES CAN BE VERY DANGEROUS and involve the risk of SERIOUS INJURY and/or DEATH. Risks include, but are not limited to contact with other students during sparring and self-defense exercises, contact with wood or other materials during board-breaking, slips, and falls, all of which can cause serious injury, paralysis and/or death.
2.) PHYSICAL CONTACT. I understand that, during the course of instruction, members of the Greenwich Martial Arts, LLC dba Devita Karate Martial Arts staff, other students and/or other authorized persons will be engaged in a course of conduct requiring PHYSICAL CONTACT. I give my full consent to such contact as is required by the training.
3.) EXPRESS ASSUMPTION OF RISK AND RESPONSIBILITY. I agree to assume responsibility for all the risks of the activity, whether above or not, EVEN THOSE RISKS ARISING OUT OF THE NEGLIGENCE OF THE RELEASEES NAMED BELOW. My/our participation in the activity is purely voluntary. I assume full responsibility for myself and any minor children for whom I am responsible, for any bodily injury, accident, illness, paralysis, death or loss of personal property even IF CAUSED, IN WHOLE OR IN PART, BY THE NEGLIGENCE OF THE RELEASEES NAMED BELOW, to the fullest extent permitted by law.
4.) RELEASE. I hereby release Greenwich Martial Arts, LLC dba Devita Karate, its principals, directors, officers, agents, employees and volunteers, and each and every landowner, municipal and/or governmental agency upon whose property an activity is conducted (''owner''), if any, (Collectively ''Releasees'') FROM ANY AND ALL LIABILITY OF ANY NATURE FOR ANY AND ALL INJURY OR DAMAGE (INCLUDING DEATH) TO ME OR MY MINOR CHILDREN OR ANY OTHER PERSONS as a result of my/our participation in the activity, EVEN IF CAUSED BY THE NEGLIGENCE OF ANY OF THE RELEASEES NAMED ABOVE OR ANY OTHER PERSON (INCLUDING MYSELF) to the fullest extent permitted by law.
5.) INDEMNITY. I hereby agree to INDEMNIFY AND SAVE AND HOLD HARMLESS the Releasees and each of them FROM ANY LOSS, LIABILITY, DAMAGE OR COST they may incur arising out of or related to my participation in any martial arts, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
I HAVE READ THIS ASSUMPTION AND ACKNOWLEDGMENT OF RISKS, RELEASE OF LIABILITY, AND INDEMNITY AGREEMENT. I UNDERSTAND THAT BY SIGNING THIS DOCUMENT, I AM WAIVING VALUABLE LEGAL RIGHTS, INCLUDING ANY AND ALL RIGHTS I MAY HAVE AGAINST THE RELEASEES, OR THEIR EMPLOYEES, AGENTS, SERVANTS OR ASSIGNS AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE AND INDEMNITY TO THE GREATEST EXTENT ALLOWED BY LAW.
By typing your name below, you acknowledge the same as your signature.
Name of Signatory
Name of Participant (if Minor)
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