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Release and Waiver of Liability and Indemnity Agreement

(Read Carefully Before Signing)

In consideration of being permitted to participate in any way in the Martial Arts Program indicated below and/or being permitted to enter for any purpose any restricted area (here in defined as any area where in admittance to the general public is prohibited), the parent(s) and/or legal guardian(s) of the minor participant named below agree:

1. The parent(s) and/or legal guardian(s) will instruct the minor participant that prior to participating in the below 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. 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 are not reasonably foreseeable at this time.

3. 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. I/We HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE the martial arts facility used by the participant, including it 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, employees, all for the purpose herein referred to as “Releasee”…From all liability to the undersigned, my/our personal representatives, assigns, executors, heirs and next to kin For any and all claims, demands, losses or damages and any claims or demands therefore 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 events(s) caused alleged to be caused in whole or in part by the negligence of the releasee or otherwise.

5. 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. 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, notwithstanding continue in full legal force and effect.

7. On behalf of the participant and individually, the undersigned partners(s) and/or legal guardian(s) for the minor participant executes this Waiver and Release. If, despite the release, the participant makes a claim against any of the Releasees, the parents(s) and/or legal guardian(s) will reimburse the Releasee for any money which they have paid to the participant, or on his behalf , and hold them harmless.

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 WTHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

Martial Arts School:  Mount Dora BJJ / Elevate Fitness / / GFL / Blackwood Properties

{first_name}

{sign_date}

Photo Release

I, {first_name}__________________________, hereby authorize Mount Dora BJJ permission to use my photograph or and all family members photographs in any and all of its publications, including but not limited to all Mount Dora BJJ printed and digital publications. I understand and agree that any photograph will become property of Mount Dora BJJ and will not be returned.

I acknowledge that since my participation with Mount Dora BJJ is voluntary, I will receive no financial compensation.

I hereby irrevocably authorize Mount Dora BJJ to edit, alter, copy, exhibit, publish or distribute this photo for purposes of publishing Mount Dora BJJ program or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy.  Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph.

I hereby hold harmless and release and forever discharge Mount Dora BJJ, from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf of my estate have or may have by reason of this authorization.

I am at least 18 years of age and am competent to contract in my own name. I have read this release before signing below and I fully understand the contents, meaning and impact of this release.

{sign_date}________________________

Participant: _________________________________________________

Signature of Participant {first_name}_______________________________________

Signature of Parent or guardian   ___________________________________

Print name of parent or guardian:_______________________________________

Please read carefully.  In signing this application, I/we understand that:

In signing this application, I/we understand and agree to the following:

Payment Policy

Cash payment is due every Friday for the following week. If cash payment is not received by the due date, an automatic draft will be debited from the account listed above, including an $8.00 processing fee. I agree to comply with Mount Dora BJJ’s payment policies.

Late Payment Fee

If payments are not received by the weekly or monthly due date, a $20.00 late fee will be applied for each occurrence until all outstanding invoices are paid.

Late Pickup Policy

If your child is not picked up by 5:30 PM, a late pickup fee will be charged (unless your child is a monthly student or prior arrangements have been made). The fee is $1.00 per minute after 5:30 PM.

Mount Dora BJJ closes at 5:30 PM every Wednesday.

Program Withdrawal

Should the Administrator/Director of Mount Dora BJJ determine, at their sole discretion, that a child should be withdrawn from participation in the program, parents will be notified in writing. Parents will be given two weeks’ notice of withdrawal, except in cases involving past-due accounts.

Summer Camp Week Selection

I will select my summer camp weeks by May 15th. If no selection is made by this date, the student may lose their spot in the camp.

I understand that I am financially responsible for all selected summer camp weeks.

Authorization

I hereby agree to all terms and conditions stated above. I also authorize Mount Dora BJJ to debit payment from my account weekly or monthly, as agreed upon.