Waiver and Liability Release Form

Waiver and Liability Release Form - Please Read Carefully Below Before Signing

In consideration of MUSHIN NYC LLC, its successors and/or assigns furnishing services and/or equipment to enable me to participate in mixed martial arts classes, fitness classes, and/or personal training, and any or all other related and/or secondary activities (collectively, the Activities), I agree as follows:

I fully understand and acknowledge that the Activities that:

(a) inherent risks, dangers, and hazards exist in my participation in the Activities, and in the use of any and all equipment involved therein;

(b) my participation in the Activities and/or use of such equipment may result in serious injury or illness including, but not limited to, bodily injury, disease, strains, fractures, partial and/or total paralysis, death or other ailments that could cause serious permanent disability;

(c) these risks and dangers may be caused by the gross or actual negligence of the owners, employees, officers or agents of MUSHIN NYC LLC, the negligence of the participants, the negligence of others, accidents, breaches of contract, forces of nature, or other causes. Risks and dangers may arise from foreseeable or unforeseeable causes including, but not limited to, instructor decision making, including that an instructor may misjudge the risks, hazards and dangers that are inherent to the Activities; and

(d) by my participation in the Activities and for use of equipment, I hereby agree that I am voluntarily participating in such activity, that I have been advised of the risks and hereby assume all risks and dangers and all responsibility for any losses and/or damages, whether caused in whole or in part by the negligence or other conduct of the owners, agents, officers or employees of MUSHIN NYC LLC, other guests, or by any other person.

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I, on behalf of myself and my successors or assigns hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify MUSHIN NYC LLC, its owners, agents, officers and employees from any and all claims, actions, or losses for bodily injury, property damage, wrongful death, loss of services or otherwise that may arise out of my participation in the Activities and/or use of any and all equipment involved therein. I specifically understand that I am releasing, discharging, and waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct by the owners, agents, officers or employees of MUSHIN NYC LLC, their successors and/or assigns.

I also agree to the following: I, the undersigned, acknowledge that I am aware of the risks and hazards involved in participating in the Activities, and I am voluntarily participating in the Activities knowing such dangers. I hereby release MUSHIN NYC LLC, its officers, employees, agents, successors and assigns, and all other persons participating on their behalf in the Activities from and against any and all liabilities, claims, demands, actions and causes of action whatsoever, arising out of or relating to any loss, damage, disability or injury (including death), that may be sustained by me in connection with my participation in the Activities. This release shall be binding upon the administrators and/or executors of my estate, my heirs and distributes. The venue of any dispute that may arise out of this agreement or otherwise between the parties to which MUSHIN NYC LLC or its agents is a party shall be the City of New York, County of New York in the State Supreme Court in New York County, New York State.

I Agree

I HAVE READ THE ABOVE WAIVER AND LIABILITY RELEASE IN FULL AND BY SIGNING IT, I VOLUNTARILY AGREE TO ITS TERMS. IT IS MY INTENTION TO EXEMPT AND RELIEVE MUSHIN NYC LLC, ITS OWNERS, AGENTS, OFFICERS AND EMPLOYEES, AND THEIR SUCCESSORS AND ASSIGNS, FROM LIABILITY FOR ANY PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE.

I Agree

Date: February 9, 2026

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First Participant Name

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First Participant Date of Birth*

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First Participant Signature*

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Emergency Contact

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Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.

By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.

Parent or Guardian's Name

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Parent or Guardian's Date of Birth*

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Electronic Signature Consent*

By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.

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