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Kingdom Combat Gym Liability Waiver and Release of Claims

Participant Waiver and Release of Liability Agreement

This Waiver and Release of Liability Agreement (“Agreement”) is entered into by the undersigned participant (or parent/legal guardian if participant is under 18 years of age) and is effective upon signature. This agreement applies to all activities and use of facilities provided by Kingdom Combat LLC, its officers, owners, instructors, volunteers, employees, agents, and subsidiaries (“Kingdom Combat”) and Crossroad Enterprise LLC, the owner and landlord of the premises located at 59 A NE St., Linton, IN 47441 (Crossroad Enterprise).

1.         Assumption of Risk

I, the undersigned, acknowledge that Brazilian Jiu-Jitsu, Wrestling, Boxing, Mixed Martial Arts, Muay Thai, and any other associated activities (hereafter “Activities”) involve inherent and significant risks, including but not limited to:

-Physical injuries (e.g., sprains, fractures, concussions, joint injuries, dislocations, or even death.

-Choking, striking, or submission techniques that may cause loss of consciousness or permanent injury

-Risks associated with use of gym equipment (weights, mats, bags, etc.)

-Unforeseen or negligent acts by other participants or instructors

I, the undersigned, assume all such risks, known and unknown, and accept full responsibility for my participation in “Activities”.

2.         Medical Fitness and Disclosure

I certify that:

-I am physically and mentally fit to participate in Activities.

-I have disclosed any relevant medical conditions (e.g., heart issues, respiratory problems, epilepsy, recent surgeries).

-I understand that Kingdom Combat LLC and Crossroad Enterprise LLC are not responsible for evaluating my health status.

I agree to immediately notify staff if I experience any unusual pain, injury, dizziness, or discomfort.

3.         Release of Liability

In Consideration of being allowed to participate in Activities and use of facilities:

I fully release and discharge:

-Kingdom Combat LLC

-Crossroad Enterprise LLC

-Their respective owners, members, officers, instructors, employees, landlords, volunteers, agents, and affiliates from any and all liability, claims, demands, or causes of action arising out of:

-Injuries (including death or permanent disability)

-Property damage or theft

-Medical or emergency costs

-Negligence of any kind (except gross negligence or intentional misconduct)

-Risks associated with other participants, equipment failure, or facility conditions 

This release applies to the fullest extent permitted by law and includes claims arising out of acts of ordinary negligence

4.         Medical Treatment Consent

I give Kingdom Combat LLC permission to seek emergency medical treatment on my behalf if I am incapacitated, and I release them from liability for such actions. I understand I am responsible for any medical costs incurred due to injuries sustained during participation. 

5.         Image and Media Release

I grant Kingdom Combat LLC permission to use my likeness (photos, video, name) in promotional material, social media, or advertising without compensation.

6.         Rules and Code of Conduct

I agree to follow all gym rules, instructions, and safety protocols, including:

-Respect for instructors and fellow students

-No unsanctioned sparring or dangerous behavior

-Clean attire and hygiene standards

-Age-appropriate conduct for minors

Violation or rules may result in expulsion without a refund.

7.         Minors (if applicable)

If the participant is under 18, I affirm that I am the parent or legal guardian, and I accept full legal responsibility on behalf of the minor. I further agree to supervise the minor’s conduct and assume all the risks and liabilities as described in this waiver.

8.         Indemnification

I agree to indemnify and hold harmless Kingdom Combat LLC and Crossroad Enterprise LLC against any claims, actions, damages, or legal proceedings, including attorney’s fees, arising from:

-My participation in Activities

-My Violation of this Agreement

-My conduct on the premises

9.         Governing Law and Venue

This Agreement shall be governed by the laws of the State of Indiana. Any legal action shall be brought exclusively in the courts of Greene County, IN.

10.    Severability

If any part of this Agreement is deemed invalid or unenforceable, the remaining portions shall remain in full force and effect.

Date: October 12, 2026

First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
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*
Middle Name
Last Name*
Relationship*
Phone*
Parent or Guardian's Date of Birth*
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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