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Owings Martial Arts

3241 Stanford Ranch Rd. Rocklin Ca. 95765

Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement

 


In consideration of participation in the class at Owings Martial Arts. I represent that I understand the nature of these Activities
and that I am in good health and in proper physical condition to participate in such Activities. I acknowledge that if I believe
event conditions are unsafe I will immediately discontinue participation in the Activities. I fully understand that these Activities
involve risks of serious bodily injury, including permanent disability, paralysis and death, which may be
caused by my own actions, or inactions, those of others participation in the event, the conditions in which the event takes place or the negligence of Owings Martial Arts ; and that there may be other risks either not known to me or not readily foreseeable at this time, and at this time I fully accept and assume all such risks and all responsibility for losses, costs, and damages I incur as a result of my participation in these Activities. I, on behalf of myself, my personal representatives and my heirs, here by voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify Owings Martial Arts and any of its owners, agents, officers, employees, volunteers, affiliates,
other participants, any sponsors, advertisers, owners and leaser of premises on which these Activities take place (Releasees) from any and all claims, actions or losses for bodily injury, property damage, wrongful death, loss of services or otherwise which may arise out of my use of any equipment or my participation in Owings Martial Arts activities. 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, employees, volunteers, other participants, any sponsors, advertisers, owners and leaser of premises of the Activity (Releases).


I have read the RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, I understand that I have given up substantial rights by signing it, and I have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.

 

 

 

 

 

 

 

 

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
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*
Check to receive information, news, and discounts by e-mail.
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.
Parent or Guardian's Name

First Name*

Middle 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.


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