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Applied Tactics and Fitness, LLC dba Krav Maga Institute Waiver and Release

1) This Waiver and Release is an agreement entered into between myself ("Participant"), and Applied Tactics and Fitness LLC, dba Krav Maga Institute ("KMI").

2) I (Buyer, Member, parent, spouse, or guest, as applicable) acknowledge that Krav Maga, and similar training, involve the use of combat techniques and that I will be engaging in activities that involve risk of injury which might result not only from my own action, inaction or negligence, but also the action, inaction or negligence of others, the rules of play, or the condition on the premises or of any equipment used. I agree that if I engage in any physical exercise or activity or use any facility on KMI’s premises, I do so at my own risk. This includes, without limitation, my use of the equipment, locker room, changing room(s), restrooms, or sidewalk, and my participation in any activity, class, program, personal training, or instruction now or in the future made available. I agree that I am voluntarily participating in these activities and using the equipment and facilities and assuming all risk of injury or my contraction of any illness or medical condition that might result therefrom or any damage, loss or theft of any personal property. I agree on behalf of myself (and my personal representatives, heirs, executors, spouse, administrators, agents and assigns or others) to release and discharge KMI (and their affiliates, employees, agents, representatives, successors and assigns) from any and all claims or causes of action arising out of KMI’s negligence. This Waiver and Release of all liability includes, without limitation, injuries which may occur as a result of (a) my use of any facility or its improper maintenance, (b) my use of any exercise equipment which may malfunction or break, (c) KMI’s improper maintenance of any exercise equipment, (d) KMI’s negligent instruction or supervision, (e) KMI’s negligent hiring or negligent retention of any employee, (f) loss of consortium, and (g) my slipping and falling while on any KMI property or on the surrounding premises.

3) I am aware that participation in Krav Maga, and similar training, carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injury. The specific risks vary from one activity to another, but the risks range from (1) minor bodily injuries such as scratches, bruises, and sprains, (2) major bodily injuries such as eye injuries or loss of sight, joint injuries, broken bones, injuries to feet, legs, hands, arms, chest, back, neck and head, heart attacks, and concussions, (3) catastrophic bodily injuries including injuries to body organs or injuries resulting in permanent disability, paralysis, and death. I am further aware that these risks may arise as a result of my own actions or inactions, or may arise from the actions or inactions of others, or may arise from rules applied to the activity, condition of the premises, or equipment used. I know, understand and appreciate these and other risks that are inherent in Krav Maga, and similar training, and I agree that my participation in The Krav Maga Activities is voluntary and that I knowingly assume all such risks. I further agree that it is my responsibility to assess the hazards and risks presented by my participation in Krav Maga, and similar training, and that I am the ultimate judge as to whether I can participate without risk of harm to myself.

4) Participant should consult with his/her physician before using KMI’s services and facilities in all events including a history of heart disease. Participant understands and acknowledges that KMI has no expertise in diagnosing, examining or treating any medical condition. Participant agrees he/she will not use the facilities with any medical condition including infections, maladies or inability to maintain personal hygiene, if such condition poses a direct threat to the health or safety of Participant or others, and agrees he/she will use the facilities in accordance with all applicable public health requirements. It is Participant's responsibility to consult with his/her physician to determine if any of these medical conditions exists and, if so, whether such condition poses a direct threat to the health or safety of Participant or others. KMI reserves the right, however, to make the final determination in this regard.

5) Participant agrees that any pictures, audio, or visual recordings taken of him/her in connection with classes or seminars can be used for publication, promotion, articles, shows and advertisement without additional consent and without compensation at this time or any other time.

6) I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF ALL LIABILITY. IN ADDITION, I DO HEREBY WAIVE ANY RIGHT THAT I MAY HAVE, BY OR ON BEHALF OF MYSELF, MY SPOUSE, OR ANY CHILD (MINOR OR OTHERWISE), TO BRING A LEGAL ACTION OR ASSERT A CLAIM FOR INJURY OR LOSS OF ANY KIND AGAINST KMI FOR NEGLIGENCE OR ARISING OUT OF OR RELATING TO PARTICIPATION BY MYSELF, MY SPOUSE, OR CHILD IN ANY OF THE ACTIVITIES, OR USE OF THE EQUIPMENT, FACILITIES, OR SERVICES KMI PROVIDES AS DESCRIBED HEREIN, OR ON ACCOUNT OF ANY ILLNESS OR ACCIDENT, OR DAMAGE TO OR LOSS OF MY PERSONAL PROPERTY. I have read and understand this release and agreement and agree to its provisions. I am not under their influence of any drugs, alcohol, or other intoxicants. I am not suffering from any illness or incapacity. I am over 18 years of age. (If not over 18 years of age, parent or guardian must sign.)

First Participant's Name

First Name*

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

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

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

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

First Name*

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

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

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

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

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

First Name*

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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:
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Parent or Guardian's Email Address

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Emergency Contact

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How did you hear about us?

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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*

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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