WAIVER/RELEASE FORM

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 defined as any area where admittance to the general public is prohibited), the parent(s) and/or legal guardian(s) of the minor participant’s name below agree:

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.

I/We fully understand and acknowledge that:

There are risk and dangers associated with participation in martial arts events and activities which could result in bodily injury, partial and total disability, paralysis, and death.

The social and economic losses and/or damages, which could result from these risk and dangers described above, could be serve.

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 releasee(s) at this time.

There may be other risk not known to us or are reasonably foreseeable at this time.

I/We accept and assume such risk and responsibility for the losses and/or damages following such injury, disability, paralysis, or death however caused and whether caused in the whole or in part by the negligence of the releasee(s) named below.

I/WE HEREBY RELEASE, WAIVE, DISCHARGE, AND CONVERT 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, employees, all for the purposes herein referred to as “Release” 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 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 EVENT(S) CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEE OR OTHERWISE.

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 INJURY RECEIVED MAY BE COMPOUNDED OR INCREASED BY THE NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEE.

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.

On behalf of the participant and individual, the undersigned partner(s) and/or legal guardian(s) for the minor participant executes the waiver and release. If, despite this release, the participant makes a claim against any of the releasee(s), the parent(s) and/or legal guardian(s) will reimburse the releasee for money which they have paid to the participant, or on his behalf, and hold them harmless.

COVID-19 RELEASE

I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.

I further acknowledge that Alton Family Martial Arts & Fitness has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.

I further acknowledge that Alton Family Martial Arts & Fitness cannot guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, gym staff, and other gym clients and their families.

I voluntarily seek services provided by Alton Family Martial Arts & Fitness and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending classes and private sessions.

I attest that:

-I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.

- I have not traveled internationally within the last 14 days.

- I have not traveled to a highly impacted area within the United States of America in the last 14 days.

- I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.

- I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non-contagious by state or local public health authorities.

- I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.

I hereby release and agree to hold Alton Family Martial Arts & Fitness harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the facility, or that may otherwise arise in any way in connection with any services received from Alton Family Martial Arts & Fitness. I understand that this release discharges Alton Family Martial Arts & Fitness from any liability or claim that I, my heirs, or any personal representatives may have against the facility with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from Alton Family Martial Arts & Fitness. This liability waiver and release extends to the facility together with all owners, partners, and employees.

I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE AND INTENDED MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

Release/Martial Arts School: Alton Family Martial Arts & Fitness

Participant's/Legal Guardian's Signature

First Name Last Name