(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 ANDCOVENANT 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 OFTHE EVENT(S) ARE VERY DANGEROUS and involve the risk of serious injury and/or death and/or property damage. Each of THEUNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BECOMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURESOF 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.
8. I herby grant permission to Breaking Point BJJ to use photographs and/or video of myself or minor participant in publications, online media, and in other communications related to the mission of Breaking Point BJJ. I understand that I may revoke this authorization at any time by notifying Breaking Point BJJ in writing. The revocation will not affect any actions taken before the receipt of the written notification.
I acknowledge that the novel coronavirus (COVID-19) is an ongoing pandemic whose nature and risk is changing frequently. I also acknowledge that this COVID-19 pandemic poses risks for all persons present on the premises of Breaking Point LLC (to include those not actively engaged in martial arts), that close personal contact of the type necessary for the practice of martial arts increases the risk of transmission of COVID-19, which can lead to injury, illness, or death for myself and others, including those not personally present. I further acknowledge that it is my responsibility to acquaint myself with information about COVID-19 from sources that include the Centers for Disease Control, the Office of the Governor of Iowa, the World Health Organization, and my physician.
I acknowledge that Breaking Point LLC, its owners, officers, directors, operators, instructors, and agents, employees, assigns, landlords, are not able to provide me with that medical information as to the nature and risks of COVID-19.
Therefore, in consideration of being permitted onto the premises of Breaking Point LLC, I acknowledge and fully assume the risk of injury, illness, or death related toCOVID-19 arising from presence on the premises and/or participating in martial arts.
I RELEASE, WAIVE, DISCHARGE, HOLD HARMLESS, AND COVENANT NOT TO SUE on behalf of myself, others, and any minor children or ward, Breaking Point LLC, its owners, officers, directors, operators, instructors ,and agents, employees, assigns, landlords for negligence or any other liability related to COVID-19 which might occur as a result from myself or others being on the premises or participating in martial arts.
I INDEMNIFY, Breaking Point LLC, its owners, officers, directors, operators, instructors, and agents, employees, assigns, landlords against any claims, lawsuit, judgments, losses, expenses, and all other costs of any kind, direct or indirect, that relate to any action brought by me, on my behalf, or on the behalf of any minor child or ward, as to negligence or any liability related to COVID-19 which might occur as a result from being on the premises or participating in martial arts.
I agree to abstain from entering the premises of Breaking Point LLC(and, if applicable, refrain from having the child or ward enter the premises Breaking Point LLC) if any of the following assertions apply to me;
I have had a fever in the last 14 days
I have had a respiratory illness such as a cough or shortness of breath in the last 14 days
I have had direct contact or a household member has had direct contact with a confirmed COVID-19 patient in the last 14 days
I understand that I am not obligated to sign this release, and that if I do not wish to sign this release I may simply decline to do so and refrain from entering the premises of Breaking Point LLC (and, if applicable, refrain from having the child or ward enter the premises Breaking Point LLC).
Having read this entire document, I understand, and agree to the foregoing, I indicate my agreement to the foregoing. I affirm that I am at least eighteen (18) years old, signing of my own free will and volition, that no statements, assurances, inducements or representation other than those contained on this page have been made, that I am competent to execute this agreement, and I intend for this agreement to bind myself as well as any assigns representatives.
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.