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Empire Ninja Yorktown Liability Waiver

Empire Ninja Yorktown LLC Liability Waiver


PARTICIPANT WAIVER AND RELEASE OF LIABILITY AND HOLD HARMLESS AGREEMENT 

THE UNDERSIGNED ACKNOWLEDGES AND AGREES THAT THE USE OF EQUIPMENT/OBSTACLES PROVIDED BY EMPIRE NINJA YORKTOWN LLC, AS WELL AS PARTICIPATION IN ANY ACTIVITY PROVIDED BY EMPIRE NINJA YORKTOWN LLC, EITHER ON MY OWN OR UNDER THE INSTRUCTION/SUPERVISION OFEMPIRE NINJA YORKTOWN LLC. EMPLOYEES, IS ENTIRELY VOLUNTARY, AT THE SOLE DISCRETION AND JUDGMENT OF THE UNDERSIGNED, AND AT THEIR OWN RISK. 

The undersigned participant acknowledges and agrees that there are substantial risks, hazards and dangers inherent in participating in activities provided by Empire Ninja Yorktown LLC and on equipment/obstacles provided by Empire Ninja Yorktown LLC. Such risks, hazards and dangers may include, but are not necessarily limited to, injury to the musculoskeletal and/or cardio respiratory systems which can result in serious injury or death. In addition, due to the extremely contagious nature of the novel coronavirus, COVID-19, there are risks of exposure or infection inherent in participating in activities where there is a congregation of a group of people and where multiple people are touching equipment/obstacles provided by Empire Ninja Yorktown LLC. Such exposure or infection can result in personal injury, illness, permanent injury or disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at activities organized or supervised by Empire Ninja Yorktown LLC may result from the actions, omissions, or negligence of myself or others, including but not limited to Empire Ninja Yorktown LLC’s members, employees, and program participants and their families. This Waiver and Release of Liability and Hold Harmless Agreement covers, without limitation, all injuries, contraction of COVID-19, and/or property damage which may occur as a result of the participant's use of all amenities and equipment provided by Empire Ninja Yorktown LLC, as well as their participation in any activity, class, program, personal training, supervised activity, or instruction, or as a result of the sudden and/or unforeseen malfunctioning of any equipment. It is the express intent of the undersigned participant to release the organizers, sponsors, participants and owners of Empire Ninja Yorktown LLC’s  business from liability. 

With this knowledge and understanding, and in consideration of the services and activities provided by Empire Ninja Yorktown LLC, the participant states as follows: 

The participant hereby waives, releases, remises, covenants not to sue and forever discharges Empire Ninja Yorktown LLC and any of their officers, agents and employees, from any and all liability, claims, demands, actions or rights of action, or damages of any kind including, but not limited to those related to, arising from, or in any way connected with participation in Empire Ninja Yorktown LLC programs/classes/events, whether or not allegedly resulting from or in any way related to the negligent acts or omissions of Empire Ninja Yorktown LLC and/or its officers, agents and/or employees or others or the malfunction of Empire Ninja Yorktown LLC’s equipment or obstacles. The participant accepts full financial responsibility for any injury to themselves or to any other participant, whether due to their own negligence or not, whether due to Empire Ninja Yorktown LLC’s  failure to use due care in its methods of owning and operating its equipment , and whether related to the participant's participation in activities provided by Empire Ninja Yorktown LLC or supervised or unsupervised use of Empire Ninja Yorktown LLC’s equipment. The participant agrees to hold harmless and indemnify Empire Ninja Yorktown LLC  and their officers, agents and employees from any loss, liability, claims, damages or costs, including court costs and attorney's fees, that they may be sought against Empire Ninja Yorktown LLC due to their participation.  The participant understands that this Waiver and Release of Liability and Hold Harmless Agreement shall apply to any and all services and activities provided by Empire Ninja Yorktown LLC from this date forward. The participant certifies that they have no medical problems that would increase the risk of illness, injury and/or death as a result of participation in a fitness program or any other activity facilitated and/or designed by Empire Ninja Yorktown LLC. The participant certifies that: a) they are not presenting any of the symptoms of COVID-19, including but not limited to fever, shortness of breath, dry cough, runny nose or sore throat; b) they have not traveled outside the United States in the past 14 days to countries that have been affected by COVID-19.

Empire Ninja Yorktown LLC is not responsible for any lost, stolen or damaged personal belongings. 

I hereby agree and give consent for Empire Ninja Yorktown LLC to record, film, photograph, audiotape or videotape my child’s name, image, and performance (herein collectively referred to as “Recordings”). I hereby consent to the use of Recordings or my child’s name for advertising, promotional or commercial purposes of any kind at the sole discretion of Empire Ninja Yorktown LLC including, but not limited to, the Empire Ninja Yorktown LLC website, brochures, blogs, all social media platforms—including, but not limited to Facebook, Instagram, YouTube, and/or for broadcasting on television or radio as determined by Empire Ninja Yorktown LLC. I understand that the Recordings may appear in electronic form on the Internet or in other publications outside of Empire Ninja Yorktown LLC’s control. I agree that I will not hold Empire Ninja Yorktown responsible for any harm that may arise from such unauthorized reproduction. I hereby waive any right to approve the use of this content now or in the future, whether the use is known to me or unknown, and I waive any right to any royalties related to the use of this content. I hereby release Empire Ninja Yorktown LLC, its officers, employees, agents and its advertising and promotional agencies from any and all claims, demands, damages, actions, causes of action whatsoever which I, my heirs, executors, administrators may now or hereafter have against them or any part of them in respect to relating to the use of the Recordings, including but not limited to libel and invasion of privacy. By signing this form, I give this consent and release voluntarily on behalf of the individual named and I understand and agree to be bound by its contents. 

By signing below, you are acknowledging and agreeing (or acknowledging and agreeing on behalf of your child if under 18) that you have carefully read and are agreeing to release and discharge Empire Ninja Yorktown LLC, and their officers, agents and employees, from any and all claims, causes of action and damages, and are agreeing voluntarily to give up or waive any right that you may otherwise have to bring a legal action against Empire Ninja Yorktown LLC, and their officers, agents and employees for personal injury or property damage. If any portion of this release shall be deemed by a Court of competent jurisdiction to be invalid, then the remainder of this release shall remain in full force. This release cannot be modified orally. 

NOTICE TO THE MINOR CHILD'S PARENT OR GUARDIAN: 

READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF EMPIRE NINJA, INC. USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED, OR MAY CONTRACT COVID-19, BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY, INCLUDING THE INABILITY OF EMPIRE NINJA YORKTOWN LLC. TO GUARANTEE THAT SOCIAL DISTANCING RULES WILL BE FOLLOWED BY PARTICIPANTS, WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD'S RIGHT AND YOUR RIGHT TO RECOVER FROM EMPIRE NINJA YORKTOWN LLC IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH OR CONTRACTION OF INFECTIOUS DISEASE, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THIS ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND EMPIRE NINJA YORKTOWN LLC HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM. 

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*
Parent or Guardian's Email Address

Email*

Confirm Email*
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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

First Name*

Middle Name

Last Name*

Relationship*

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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