AUTHORITY TO TREAT
I, the undersigned, give the instructors, staff, and responsible adults the power to authorize medical or other treatment of the person named under “Student Name”. If I am not the person so named, I am the parent, guardian, or adult responsible for the person named, and I have the legal right to grant this power. Treatment may be made without regard to whether I or any other parent, guardian, or adult responsible has been contacted or has consented to the specific treatment. This authority begins on the date signed and continues indefinitely.
By giving my authorization, I assume responsibilities for all decisions made, provided they are reasonable decisions under the circumstances based upon the knowledge and understanding of the person making the decisions, and I trust their judgment and offer the benefit of the doubt to them in any claim or legal proceeding. This presumption may only be overcome by clear and convincing evidence that they acted with malice or willful gross negligence, and, if so, they may still be liable.
I understand that the instructors, senior students, or others may have some skills in first aid, CPR, and, at their discretion, I authorize them to use those skills and techniques to assist in any circumstance in which they judge their skills would be necessary or helpful.
ADVISORY OF RIGHTS AND RESPONSIBILITIES
Safety is not the sole responsibility of instructors and staff. Everyone in class is responsible for their own safety and the safety of those around them.
All students have the right and responsibility to excuse themselves from any exercise they believe will be harmful to them. All students must evaluate each situation in the context of their skill and current physical condition and conduct each drill in a manner that is safe. If an instructor gives an instruction that is unsafe for the student, it is the student’s responsibility to inform the instructor that the skill may be unsafe. The instructor will routinely excuse the student from unsafe exercises and drills. The instructor may ask for an explanation, and the student is expected to provide one.
All students have a responsibility to train and conduct themselves in a manner that helps all students and instructors remain safe. Students must give those who are training enough room to avoid interfering with, and avoid being accidentally struck by, someone else practicing.
In the event of an injury, students have the right and responsibility to evaluate the extent of harm, stopping what they are doing even if it includes a partner, and determining that it is safe to continue. Unless a student is certain that further practice will not create or worsen a problem, all students are encouraged to stop what they are doing and inform an instructor. In the event of a serious injury, or appearance of a serious injury, all students, instructors, staff, and visitors, notably parents, have the right to call a stop to a particular training exercise.
If a student notes an unsafe training situation which may include a student performing a skill incorrectly, a student not being careful about others, a defect in a piece of training equipment, a potentially dangerous obstacle or condition on the floor, or anything else that may cause or lead to harm of students, instructors, staff, visitors, or guests, then the student is expected to correct the situation if within his or her ability, or notify an instructor or staff member immediately. If something is simple to correct, such as picking up equipment left on the floor, the student should correct the situation. If the situation may require the authority of the instructor of staff, or if it is not a simple matter, then an instructor or staff member should be notified immediately.
ASSUMPTION OF RESPONSIBILITIES AND RISK
Martial arts/performance training/fitness training are potentially dangerous activities. Bumps, bruises, scrapes, scratches, and soreness are commonplace, and most students will encounter this sort of minor injury from time to time in their training. More serious injuries are possible, including but not limited to sprains, strains, twists, cramps, and injuries of similar magnitude. The possibility of more serious injury exists, including but not limited to fractured bones, broken bones, torn ligaments, though not all students encounter such serious injuries. There remains, despite safety precautions, the remote possibility of crippling or death, though this is certainly not expected in any martial arts/performance training/fitness class.
I understand the above statement of risk, and I understand the rights and responsibilities of students. I assume responsibility for my own safety (or the safety of my child), understanding and accepting the risks involved with martial arts/performance training/fitness training. Even if the instructor has informed me that no serious injuries have ever happened in this facility or with any of the instructors, I understand that this does not mean that there is no possibility of harm. By assuming this risk, I completely absolve all owners, instructors, staff, students, guests, visitors, landlords, management companies, and any and all other parties of liability for my harm, unless due to gross negligence or intentionally caused in criminal conduct.
ASSUMPTION OF RESPONSIBILITIES AND RISK OF COVID-19
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. It is believed that an individual can be in infected with COVID-19 without their knowledge and be asymptomatic. Despite preventive measures, Impact Jiu Jitsu cannot guarantee that I (or my child if a parent) or anyone else will not become infected with COVID-19, including my spouse, guests, child, unborn child, or relatives. Participation in martial arts/performance training/fitness training could increase the risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I (or my child if a parent) may be exposed to or infected by COVID-19 by participating in martial arts/performance training/fitness training, and that such exposure or infection may result in personal injury, illness, permanent disability, and death to myself, my spouse, guests, child, unborn child, or relatives.
I understand that the risk of becoming exposed to or infected by COVID-19 at an Impact Jiu Jitsu academy, related event, or activity may result from the actions, omissions, or negligence of myself or others, including, but not limited to, Impact Jiu Jitsu employees, volunteers, and program participants. I understand and voluntarily accept and assume all the foregoing risks related to COVID-19 and accept sole responsibility for any injury or illness that may occur. Further, I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of Impact Jiu Jitsu, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Impact Jiu Jitsu class, related event, or activity.
NOTICE AND CONSENT OF PHYSICAL CONTACT
Complete martial arts training involves a wide variety of skills. While practicing these skills, students may have contact with any portion of the body. The groin may be the target of kicks, strikes, and grabs. The chest, buttocks, groin, or any part of the body may be contacted by any part of the training partner’s body during training of martial arts techniques, or incidentally contacted while performing a martial arts technique targeting another portion of the body.
When male and female students train together, or when adult and minor students train together, and in any other training combination, the purpose and intent of the class, instructors, and staff is to provide an environment for all students to learn and practice martial arts and self-defense in a respectful manner. Students are expected to conduct themselves appropriately at all times to ensure the best training results for everyone.
Should any student feel a training partner is engaging in contact beyond the scope of training, or a training partner is taking undue and unacceptable advantage of training contact, or if a student is made uncomfortable by any training exercise or partner, then that student has the right to withdraw from the exercise or drill. If the conduct of the training partner appears inappropriate, the student should inform an instructor. If the conduct of the training partner or any training partner appears criminal, then an instructor should be informed and the authorities may be notified either by the student or the instructor, or both.
I understand the nature of physical contact in martial arts training, and I understand that I have the right to immediately withdraw from any exercise or drill in which the conduct of any party seems beyond the scope of training or makes me uncomfortable. I agree to abide by school etiquette in all matters pertaining to training, and I shall not in any way conduct myself inappropriately or take inappropriate advantage of the contact martial arts training allows.
ADVISORY OF MEDICAL EXAMINATION AND PHYSICIAN ADVICE
Because martial arts/performance training/fitness training are physically-based, athletic activities, there are inherent risk including but not limited to: muscle and/or joint injuries or soreness, neurological and/or vascular injuries, increased blood pressure and elevated stress levels, as well as the possibility of more serious injuries including fractures or torn ligaments; and a remote possibility of crippling or death. As such, participants must be in reasonably good health and physical condition. Those who are not in reasonably good health and physical condition due to age, illness, disability, infirmity, or any other reason, should not participate in such activity. Before undertaking such an activity, a student (or parent of a student) is advised to obtain a physical examination by a qualified physician and to seek a physician’s advice regarding whether or not the student should participate in such activity. If a student suffers from any type of ongoing or recurrent medical problem or physical limitation, it is essential that the student seek the advice of a physician before engaging in martial arts/performance training/fitness training. During any martial arts training or exercise, if you feel dizzy or faint or experience any pain whatsoever, you must stop immediately and without delay seek the advice of a physician or health care professional.
I understand the above statements, particularly that I should obtain a physical examination and physician’s advice as to whether or not I should engage in martial arts/performance training/fitness training. If I am a parent of a minor child enrolling in the class, I understand that my child should receive a physical examination and physician’s advice as to whether or not my child should engage in martial arts/performance training/fitness training. I understand and agree that I assume any and all risks of any injury and harm that may result from my failure to both obtain a physical examination and a physician’s advice for myself (or for my child if a parent) before I (or my child if a parent) undertakes martial arts/performance training/fitness training. Further, I agree to completely absolve all owners, instructors, staff, students, visitors, guests, landlords, management companies, and any other parties for any injury or harm I (or my child if a parent) may receive as a result of my failure to obtain a physical examination and physician’s advice for myself (or for my child if a parent).
By participating in martial arts/performance training/fitness training, I am certifying that I am in reasonably good health and physical condition and am capable of taking part in such activity, regardless of whether or not I have received a physical examination or sought the advice of a physician. If I am a parent of a child participating in martial arts/performance training/fitness training, I am certifying that my child is in reasonably good health and physical condition and is capable of taking part in such activity, regardless of whether or not my child has received a physical examination or sought the advice of a physician.
INDEMNIFICATION BY PARENTS
Applicable only to Parents Enrolling Minor Child
I agree not to bring any claim or suit against the owners, instructors, staff, guests, students, landlord, or any other parties on behalf of my child for any injury or harm sustained by any event short of gross negligence or a criminal act, and if applicable, only the criminal shall be the subject of such a claim. I further agree that I will not cause to be brought, nor encourage, a claim or suit. I also agree not to cooperate in the bringing of such a suit or claim except insofar as I may be legally required to do so. Finally, I shall indemnify the owners, instructors, staff, guests, students, and any and all additional defendants covered by this agreement for all judgments, costs, attorney fees, and other expenses incurred as a result of a breach of this agreement.
Should any dispute arise between me, my child, or anyone acting on behalf of my child, regarding these activities, and then I specifically agree that the dispute shall be resolved in binding arbitration. Should a suit be filed in Court, I specifically authorize the Court to order the case to binding arbitration.
If any clause, sentence, phrase, or statement is found unenforceable or invalid by any Court of law, the remainder of the document shall remain valid and enforceable, and the invalid clause, sentence, phrase, or statement shall be considered struck from the document.
This document is effective from the date signed with no expiration. Furthermore, the terms of this document are retroactive to the beginning of training and visiting the class if this document was signed after that date.
I have read this Waiver document in its entirety, and I understand the complete content of it. I understand I can disagree and refuse to sign this waiver, and there are many other martial arts schools in the community to choose from. By signing below, I wish to participate at this school and agree to abide by the terms of this waiver agreement.
June 4, 2023