Loading...

AGREEMENT, WAIVER, AND LIABILITY RELEASE
ONE WORLD SELF DEFENSE & FITNESS

 

 

1. Voluntary Participation. I, acknowledge that I have voluntarily applied to participate in training to learn and practice self-defense techniques, martial arts, fitness and other related activities (collectively, "Self-Defense & Fitness Activities") at the premises of Five Families Martial Arts, Inc., a California corporation, doing business as One World Self Defense & Fitness, located at 33415 Western Ave., Union City, California 94587.

2. Assumptions of Risk. I am aware that participation in self-defense and fitness activities is a hazardous activity. I understand that I may be injured by falls, improper or negligent acts of training partner(s), misuse or failure of equipment, etc. I am voluntarily participating in the self-defense and fitness activities with knowledge of the danger involved, and I hereby agree to accept any and all risk of injury or death.

I Agree

3. No Adverse Medical Conditions. I acknowledge that training in Self-Defense & Fitness Activities may be physically challenging. I warrant that I consider myself to be in suitable physical condition and that I have not been advised by any medical professional to avoid strenuous physical activity nor am I aware of any condition which might make my participation in Self-Defense & Fitness Activities medically hazardous for myself or others.

I Agree

4. Release. As consideration for being permitted by Five Families Martial Arts, Inc., to participate in the Self-Defense & Fitness Activities and use the related facilities, I hereby agree that I, my assignees, heirs, distributee, guardians, and legal representatives will not make a claim against, sue, or attach the property of Five Families Martial Arts, Inc., its owners, manager, directors, officers, employees, agents, volunteers, contractors; its licensors: The Krav Maga Alliance, CrossFit Inc., their officers, officials, agents, employees and/or volunteers; and/or other participants in the Self-Defense & Fitness Activities or the owner of the premises in which the Self-Defense & Fitness Activities are conducted (collectively, the "Released Parties"), on account of injury or damage resulting from the negligence or other acts, howsoever caused, by any Released Party as a result of my participation in the Self-Defense & Fitness Activities. I hereby release the Released Parties from all actions, claims or demands that I, my assignees, heirs, distributee, guardians, and legal representatives now have or may hereafter have for injury or damage resulting from my participation in the Self-Defense & Fitness Activities.

5. Indemnity. To the fullest extent permitted by law, I will protect, indemnify, defend and hold the Released Parties harmless from and against any and all (a) demands, claims and/or suits made by my assignees, heirs, distributee, guardians, or legal representatives or (b) losses, damages, claims, or liability for any damage to any property or injury, illness or death of any person when such damage, injury, illness or death shall be caused in whole or in part by my negligence or willful misconduct (including without limitation when such damage, injury, illness or death shall have been caused in party by the active or passive negligence of the Released Parties). I agree to reimburse any party indemnified under this Agreement for any attorneys' fees and costs incurred in defending any action contemplated by this Paragraph. For all purposes under this Agreement and Release from Liability, any deliberate action on the part of Five Families Martial Arts, Inc., its owners, managers, officers, directors, agents, employees, volunteers or contractors, taken in good faith in the exercise of such persons' assigned duties and responsibilities shall not constitute negligence or willful misconduct.

6. KNOWING AND VOLUNTARY EXECUTION. I have carefully read this release and fully understand its contents. I am aware that this is a release of liability and a contract between me and Five Families Martial Arts, Inc., and sign it of my own free will.

7. PHOTOGRAPHY/VIDEO RELEASE Participants involved in any activities offered by Five Families Martial Arts, Inc. may be photographed or videotaped during training. The undersigned hereby consents to the use of these photographs and/or videos without compensation, on the website or in any editorial promotional or advertising material produced or published by Five Families Martial Arts, Inc.

Date: June 4, 2023 , at Union City, California.

 

Crossfit One World & Self Defense

I,in consideration for continued access to the training facility identified herein as CrossFit One World & Self Defense -Krav Maga, Bootcamp, Gymnastics & Yoga, do hereby acknowledge the significant risks associated with the physical training and programming at this facility. I acknowledge and attest to having fully and carefully read and reviewed this "RELEASE AND WAIVER" including all subparagraphs prior to engaging in any physical activity at this facility.

Rhabdomyolysis (hereinafter referred to as "Rhabdo") can occur when an individual's (Initials) physical activity is so intense that muscular cells begin to breakdown and the contents and/or remaining materials enter the bloodstream. Rhabdo may be caused by many other systemic or environmental causes. However, Exertional Rhabdo can occur in athletes of all levels of fitness, resulting in muscle cell destruction. The skeletal muscle breakdown impairs kidney function as those organs are unable to handle increased enzymes that are released into the bloodstream. This induces severe physiological changes in the body.

I Agree

The symptoms of Rhabdo include muscle pain, stiffness and extreme weakness, darkening of (Initials) the urine (similar to the color of tea or cola), decreased urine output, altered mental status, swelling of the body part involved, either with or without pain.

I Agree

I understand and have been advised that generally the pain that is referred to as a Rhabdo (Initials) symptom is pain out of proportion to the amount of soreness that one would generally expect, often producing pain much quicker than one would expect after a workout.

I Agree

I understand that any concerns on my part that I am experiencing any of the symptoms of (Initials) Rhabdo require immediate presentation to a hospital for emergency treatment. I acknowledge that no third party, either from the facility or otherwise, will be capable of monitoring my urine output or color, and it is my responsibility to be continually cognizant of this symptom and all other symptoms and to monitor them in my own body at all times. I agree that I will remove myself from participation and seek medical treatment of my own accord should I have any concerns regarding possible symptoms of Rhabdo.

I Agree

I acknowledge and understand that all individuals engaged in demanding workouts are (Initials) (Initials) potentially exposing themselves to Rhabdo or other injuries/negative physical results. However, I understand that statistically individuals most likely to experience Rhabdo are those who are in good shape by general standards or who were previously in good physical shape. This includes individuals who were prior athletes and/or prior military personnel, law enforcement or firefighters. I acknowledge that often the more mentally tough a potential athlete is and the more athletic they were in the past or currently are, the greater the risk of exposure to Rhabdo.

I Agree

I acknowledge and fully understand that statistically the chances of me developing Rhabdo (Initials) are extremely slight, but I likewise appreciate the necessity that I be aware of the symptoms of this condition. I agree to monitor myself in a manner that is proportionate to the potential injury that can be occasioned by this condition. I acknowledge and understand that I am the only individual capable of determining if I am experiencing Rhabdo symptoms. I hereby agree and do willingly assume responsibility for any risks that I expose myself to and accept full responsibility for any injury or death that may result from participating in this significantly demanding physical activity.

I Agree

With the opportunity to fully inform myself about Rhabdo and the risks thereof, I knowingly (Initials) and freely assume and accept all such risks both known and unknown. I assume full responsibility and all risks from my participation in any physical activity at the facility. I for myself and on behalf of my heirs, assigns, personal representatives and/or next of kin, forever WAIVE, RELEASE, DISCHARGE and COVENANT NOT TO SUE CrossFit One World & Self Defense -Krav Maga, Bootcamp, Gymnastics & Yoga and/or their officers, directors, representatives, partners, officials, principals, agents or employees, subsidiaries, or assigns, as well as their independent contractors.

 

Cancellation Policy

I Agree

Membership hold requests must be submitted no less than 3 days before your forthcoming scheduled renewal date. 

​All Membership payments are non-refundable. Membership may be put on hold for a maximum of three (3) months per year. 

​Upon expiration of the hold period your account will automatically reactivate and regular membership payments will resume. If you choose to cancel your membership during the hold period, the standard 30 day written cancellation notice requirement stated in your membership agreement is applicable. If you choose to reactivate your membership after it is cancelled. 

​If you choose to reactivate your membership after it is cancelled, membership rates in effect at the time of reactivation will be be applicable (membership rates are subject to change). 

 

Late Payment / Declined Credit Card fees

I Agree

​Late payment/declined credit card fee of $35 will be charged on any payment past due. 

Please select who will be participating...
AdultMinor
Continue
First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!