{name} {dob}
{address}
{phone}
{contact_name} {contact_phone} {contact_relation}
1.RecognizeandunderstandthatMartialArtstrainingisaphysicalcontactactivityandthatmyparticipationmightresultin serious injury, including permanent disability or death;
2.Recognizeandunderstandthatsuchriskmaybeduetonotonlymyownactions,butalsotheaction,inactionornegligence of others;
3.Recognizethattheremaybeotherrisksthatarenotknowntomeortoothersornotreasonablyforeseeableatthistime;
4.Agreetoinspectthefacilities,equipmentandpairingspriortoparticipation.IwillimmediatelyinformaninstructorifI believe that anything is unsafe or beyond my capability and refuse to participate;
5.Assumeallforegoingrisksandacceptpersonalresponsibilityforanydamagesthatmayresultfrominjury,disabilityor death;
6.Entermartialartstrainingand/orcompetitionentirelyofmyownfreewillandunderstandtheimportanceoffollowingthe rules of training and competition;
7.CertifythatIamingoodphysicalcondition,andhavenodisease,injuryorotherconditionthatwouldimpairmy performance or physical and mental well-being during intense training practice and/or competition;
8.Grantpermissionincaseofinjurytohaveadoctor,nurse,athletictrainingorotheremergencymedicalpersonnelprovide me with medical assistance or treatment for such injury;
9.Release,waive,dischargeandcovenantnottosueTeamLawtonMartialArtsanditsgoverningbodies,instructorsand personnel, other members of the organization, participants, supervisors, coaches, sponsoring organizations or their agents, and if applicable, owners and leasers of the premises from any and all liability to the undersigned his or hers heirs and next of kin for any and all claims, demands, losses and damages which may be sustained and suffered on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by negligence of the releases or otherwise.
I HAVE READ THE ABOVE WARNING, WAIVER, RELEASE AND AGREEMENT TO PARTICIPATE. I UNDERSTAND ITS CONTENTS AND DO HEREBY SIGN IT VOLUNTARILY.