General Liability Waiver Form - Invictus Krav Maga

ATTN: If you are filling out this form for a minor, we need the name and DOB of the minor, but all other fields should have the parent's contact information.

Student First Name*

Student Last Name*

Street Address*

City*

State*

ZIP*

Cell Phone Number*

EMAIL*

Student Date of Birth*

Student Date of Birth

I acknowledge, appreciate and agree that:

1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exists; and,

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

3. I willingly agree to comply with the stated and customary terms and conditions for participation. If however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the Company immediately; and,

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, IDEMNIFY, AND HOLD HARMLESS ROLL DE BONES, LLC; d/b/a INVICTUS KRAV MAGA and INTERNATIONAL KRAV MAGA FEDERATION; their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lesser of premises used for the activity (“releases”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law; and,

5. I am aware that, by clicking the box below, I am now considered a “participating member” of Invictus Krav Maga and freely take part in its training; and,

6. I am aware that ROLL DE BONES, LLC; d/b/a INVICTUS KRAV MAGA will close to observe various holidays and I will not seek reimbursement for those holidays. I am aware that I may review these holidays on the website prior to joining; and,

7. Further, I acknowledge and give my permission to exhibit my image or video on the website and all social media platforms pertaining to ROLL DE BONES, LLC; d/b/a INVICTUS KRAV MAGA and the INTERNATIONAL KRAV MAGA FEDERATION.

By checking this box, I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDRSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.