RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT
PLEASE READ CAREFULLY
Participant: {name}
Date of Birth: {dob}
Address: {address}
Phone: {phone}
Martial Arts Program/Facility: Gracie United Bayou Lafourche / Bayou Lafourche Jiu Jitsu
Emergency Contact: {contact_name}
Emergency Contact Phone: {contact_phone}
Relationship: {contact_relation}
In consideration of being permitted to participate in any way in the Martial Arts Program indicated above and/or being permitted to enter for any purpose any restricted area (herein defined as any area where admittance to the general public is prohibited), the parent(s) and/or legal guardian(s) of the minor participant named above agree:
1. Inspection and Unsafe Conditions
The parent(s) and/or legal guardian(s) will instruct the minor participant that prior to participating in the martial arts activity or event, he or she should inspect the facilities and equipment to be used, and if he or she believes anything is unsafe, the participant should immediately advise the officials of such condition and refuse to participate.
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. Acknowledgment of Risks
I/WE fully understand and acknowledge that:
(a) There are risks and dangers associated with participation in martial arts events and activities which could result in bodily injury, partial and/or total disability, paralysis, and death.
(b) The social and economic losses and/or damages which could result from these risks and dangers described above could be severe.
(c) These risks and dangers may be caused by the action, inaction, or negligence of the participant or the action, inaction, or negligence of others, including, but not limited to, the Releasees named below.
(d) There may be other risks not known to us or not reasonably foreseeable at this time.
3. Assumption of Risks
I/WE accept and assume such risks and responsibility for the losses and/or damages following such injury, disability, paralysis, or death, however caused and whether caused in whole or in part by the negligence of the Releasees named below.
4. Release of Liability
I/WE HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE the martial arts facility used by the participant, including its owners, managers, promoters, lessees of premises used to conduct the martial arts event or program, premises and event inspectors, underwriters, consultants, and others who give recommendations, directions, or instructions to engage in risk evaluation or loss control activities regarding the martial arts facility or events held at such facility, and each of them, their directors, officers, agents, and employees, all for the purposes herein referred to as “Releasees,” FROM ALL LIABILITY TO THE UNDERSIGNED, my/our personal representatives, assigns, executors, heirs, and next of kin FOR ANY AND ALL CLAIMS, DEMANDS, LOSSES OR DAMAGES AND ANY CLAIMS OR DEMANDS THEREFOR ON ACCOUNT OF ANY INJURY, INCLUDING BUT NOT LIMITED TO THE DEATH OF THE PARTICIPANT OR DAMAGE TO PROPERTY, ARISING OUT OF OR RELATING TO THE EVENT(S), CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
5. Dangerous Activities and Rescue Operations
I/WE HEREBY acknowledge that THE ACTIVITIES OF THE EVENT(S) ARE VERY DANGEROUS and involve the risk of serious injury and/or death and/or property damage.
Each of THE UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES.
6. Scope and Severability
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 Province or State in which the event is conducted and that, if any portion is held invalid, it is agreed that the balance shall nevertheless continue in full legal force and effect.
7. Parent/Guardian Agreement and Indemnity
On behalf of the participant and individually, the undersigned parent(s) and/or legal guardian(s) of the minor participant execute this Waiver and Release.
If, despite this release, the participant makes a claim against any of the Releasees, the parent(s) and/or legal guardian(s) will reimburse the Releasees for any money which they have paid to the participant or on his or her behalf, and hold them harmless.
8. Physical Contact and Participation Consent
I hereby acknowledge and understand that Brazilian Jiu Jitsu and Wrestling are physical activities and that learning self-defense skills involves some physical contact.
Gracie United Bayou Lafourche (Gracie United LLC), its staff, and students are not to be held liable or responsible for any risks and/or injuries as a result of training Brazilian Jiu Jitsu or Wrestling.
The person signing below consents to the student participating in the classes/training and is aware of the risks involved in such participation.
9. Additional Release
The people stated in this contract hereby hold Gracie United Bayou Lafourche, its successors, assigns, owners, officers, directors, employees, and agents harmless from all claims which may be brought against them by the people stated in this contract, the student, or on the student’s behalf for any such injuries or claims, and do hereby forever release and discharge Gracie United Bayou Lafourche, its successors, assigns, owners, officers, directors, employees, and agents from all claims, demands, injuries, damages, actions, losses, and expenses.
10. Photo and Video Permission
I hereby give permission for images of my child, captured for purposes of Brazilian Jiu-Jitsu through video, photo, and digital camera, to be used solely for the purposes of Bayou Lafourche Jiu Jitsu promotional material and publications, and waive any rights of compensation or ownership thereto.
ACKNOWLEDGMENT
I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, 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 A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.
Student / Parent / Legal Guardian Signing:
Date Signed: {sign_date}
