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MATTIME®
WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT 
(Read Carefully Before Signing)

In consideration of being permitted to participate in any way in our Martial Arts Program, Conditioning/Fitness, Wrestling or other Combat Art indicated below and/or being permitted to enter for any purpose any restricted area (here in defined as any area where in admittance to the general public is prohibited), the parent(s) and/or legal guardian(s) of the minor participant named below agree:

1. The parent(s) and/or legal guardian(s), if the participant is a minor, will instruct the minor participant that prior to participating in the below martial arts, fitness or other combat art or physical activity or event, he or she should inspect the facilities and equipment to be used, and if he or she believes anything is unsafe, the participant should immediately advise the officials of such condition and refuse to participate. I understand and agree that, if at any time, I feel anything to be UNSAFE; I will immediately take all precautions to avoid the unsafe area and REFUSE TO PARTICIPATE further.

2. I/We fully understand and acknowledge that:

  • There are risks and dangers from participation in martial arts, conditioning/fitness, wrestling, jiu jitsu or other combat arts events and activities which could result in bodily injury partial and/or total disability, paralysis and death.
  • The social and economic losses and/or damages, which could result from these risks and dangers described above, could be severe.
  • These risks and dangers may be caused by the action, inaction or negligence of the participant or the action, inaction or negligence of others, including, but not limited to, the Releasees named below.
  • Wrestling, Jiu Jitsu, Martial Arts and mats used for Fitness along with the physical interaction of our customers can bring exposure to viruses (inclusive of COVID-19) skin diseases, fungi and bacteria. Despite our best efforts to keep the mats, surfaces, bathrooms, seats and door handles clean and disinfected, it is important for all kids and adults that enter and/or participate at MatTime to exercise personal physical hygiene inclusive of hand-washing before, during and after class and to shower or bathe following training.
  • There may be other risks not known to us or are not reasonably foreseeable at this time.

3. I/WE accept and assume such risks and responsibility for the losses and/or damages following such infection, injury, disability, paralysis or death, however caused and whether caused in whole or in part by the negligence of the Releasees named below.

4. I/We HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE the martial arts / wrestling facility used by the participant, including it owners, managers, promoters, lessees of premises used to conduct the martial arts event or program, premises and event inspectors, underwriters, consultants, contractors and others who give recommendations, directions or instructions to engage in risk evaluation or loss control activities regarding the martial arts facility or events held at such facility and each of them, their directors, officers, agents, employees, contractors all for the purpose herein referred to as “Releasee”...From all liability to the undersigned, my/our personal representatives, assigns, executors, heirs and next to kin For any and all claims, demands, losses or damages and any claims or demands therefore on account of any injury, including but not limited to the death of the participant or damage to property, arising out of or relating to the events(s) caused alleged to be caused in whole or in part by the negligence of the releasee or otherwise.

5. I/We HEREBY acknowledge that THE ACTIVITIES OF THE EVENT(S) CAN BE VERY DANGEROUS and involve the risk of injury and/or death and/or property damage. Each of THE UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT FIRST AID OR PROCEDURES OF THE RELEASEES.

6. EACH OF THE UNDERSIGNED further expressly agrees that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by the laws of California in which the
training facility is located and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding continue in full legal force and effect.

7. On behalf of the participant and individually, the undersigned partners(s) and/or legal guardian(s) for the minor participant executes this Waiver and Release. If, despite the release, the participant makes a claim against any of the Releasees, the parents(s) and/or legal guardian(s) will reimburse the Releasee for any money which they have paid to the participant, or on his behalf , and hold them harmless.

I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WTHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

 

 DATE: January 15, 2025

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

Name of Class (i.e. Kids Wrestling, Kids Jiu Jitsu, Adult Jiu Jitsu, Fitness, High School Wrestling..etc): *

I HEREBY CERTIFY that I have 
 personal health insurance.


My insurance company is:
First Participant's Signature*
Second Participant's Name

First Name*

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

Name of Class (i.e. Kids Wrestling, Kids Jiu Jitsu, Adult Jiu Jitsu, Fitness, High School Wrestling..etc): *

I HEREBY CERTIFY that I have 
 personal health insurance.


My insurance company is:
Third Participant's Name

First Name*

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

Name of Class (i.e. Kids Wrestling, Kids Jiu Jitsu, Adult Jiu Jitsu, Fitness, High School Wrestling..etc): *

I HEREBY CERTIFY that I have 
 personal health insurance.


My insurance company is:
Fourth Participant's Name

First Name*

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

Name of Class (i.e. Kids Wrestling, Kids Jiu Jitsu, Adult Jiu Jitsu, Fitness, High School Wrestling..etc): *

I HEREBY CERTIFY that I have 
 personal health insurance.


My insurance company is:
Fifth Participant's Name

First Name*

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

Name of Class (i.e. Kids Wrestling, Kids Jiu Jitsu, Adult Jiu Jitsu, Fitness, High School Wrestling..etc): *

I HEREBY CERTIFY that I have 
 personal health insurance.


My insurance company is:
Sixth Participant's Name

First Name*

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

Name of Class (i.e. Kids Wrestling, Kids Jiu Jitsu, Adult Jiu Jitsu, Fitness, High School Wrestling..etc): *

I HEREBY CERTIFY that I have 
 personal health insurance.


My insurance company is:
Seventh Participant's Name

First Name*

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

Name of Class (i.e. Kids Wrestling, Kids Jiu Jitsu, Adult Jiu Jitsu, Fitness, High School Wrestling..etc): *

I HEREBY CERTIFY that I have 
 personal health insurance.


My insurance company is:
Eighth Participant's Name

First Name*

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

Name of Class (i.e. Kids Wrestling, Kids Jiu Jitsu, Adult Jiu Jitsu, Fitness, High School Wrestling..etc): *

I HEREBY CERTIFY that I have 
 personal health insurance.


My insurance company is:
Ninth Participant's Name

First Name*

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

Name of Class (i.e. Kids Wrestling, Kids Jiu Jitsu, Adult Jiu Jitsu, Fitness, High School Wrestling..etc): *

I HEREBY CERTIFY that I have 
 personal health insurance.


My insurance company is:
Tenth Participant's Name

First Name*

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

Name of Class (i.e. Kids Wrestling, Kids Jiu Jitsu, Adult Jiu Jitsu, Fitness, High School Wrestling..etc): *

I HEREBY CERTIFY that I have 
 personal health insurance.


My insurance company is:
Parent or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

First Name*

Last 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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

Name of Class (i.e. Kids Wrestling, Kids Jiu Jitsu, Adult Jiu Jitsu, Fitness, High School Wrestling..etc): *

I HEREBY CERTIFY that I have 
 personal health insurance.


My insurance company is:
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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