Steve's Gym / Elkhart Martial Arts / EMA South
Liability Waiver and Release from Liability Form
The undersigned participant, ____________________________ , on behalf of him or herself if eighteen (18) years of age or older, or if under eighteen (18) years of age by his or her parent or legal guardian (“Participant”) in consideration of being permitted to participate in any way in the martial arts program of Elkhart Martial Arts, does hereby waive and release, indemnify, save and hold Elkhart Martial Arts harmless from any loss, liability, attorney’s fees, damages, or costs, and its agents, employees, officers, directors, affiliates, successors and assigns, of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilities, of every kind and nature, whether known or unknown, in law or equity, that Participant ever had or may have, arising from or in any way related to Participant’s participation in the martial arts program conducted by, on the premises of, or for the benefit of, Elkhart Martial Arts, provided that this waiver of liability does not apply to any acts of gross negligence, or intentional, willful or wanton misconduct.
I hereby voluntarily assume full responsibility for any and all risks, known or unknown, foreseeable or unforeseeable, arising from participation in these activities.
I further agree to release, indemnify, defend, and hold harmless Steven E. Travis, Steve’s Gym, Elkhart Martial Arts Academy, Elkhart Martial Arts Campus, Elkhart Martial Arts South, Zion Missionary Church, the Pilsung Foundation, all instructors, assistant instructors, associates, guest instructors, volunteers, landlords, property owners, the North American Tae Kwon Do Association, CMHUSA, and any affiliates involved in any teaching, training, or fitness program associated with this organization, from any and all liabilities, claims, demands, actions, or causes of action , whether arising from negligence or otherwise, except in cases of gross negligence or willful misconduct .
I certify that I am physically capable of participating in these activities and have no medical condition that would prevent safe participation. In the event of an emergency, I authorize staff to secure medical treatment as deemed necessary and understand that I am financially responsible for all medical expenses incurred.
No Refunds, Participant further understands and agrees that Elkhart Martial Arts does not provide a refund (partial or otherwise) in the event that Participant is unable to participate in the sport during any time period in which membership at Elkhart Martial Arts has been pre-paid. All funds paid to Elkhart Martial Arts, whether for clothing, fitness supplies, membership dues, travel, or for any other purpose, are non-refundable. Participant also understands that if Participant needs to pause non-prepaid membership, Participant will provide thirty (30) days advanced notice for all membership changes. Cancellation will be effective after the next scheduled payment has processed.
Media Release:
I grant permission to the above-listed organizations and affiliates to take and use photographs, video recordings, or other images of me (or my child) for promotional, educational, instructional, and marketing purposes in print, online, and on social media platforms. I understand that I will not receive compensation for the use of these images and that they may be used without limitation unless I provide written notice withdrawing this consent.
Acceptance of Agreement. I, ________________________ (the Participant), HAVE READ, UNDERSTAND AND FULLY AGREE TO THE TERMS OF THIS WAIVER AND RELEASE. I UNDERSTAND AND CONFIRM THAT BY SIGNING THIS WAIVER AND RELEASE I HAVE GIVEN UP CONSIDERABLE FUTURE LEGAL RIGHTS. I HAVE SIGNED THIS AGREEMENT FREELY, VOLUNTARILY, UNDER NO DURESS OR THREAT OF DURESS, WITHOUT INDUCEMENT, PROMISE OR GUARANTEE BEING COMMUNICATED TO ME. MY SIGNATURE IS PROOF OF MY INTENTION TO EXECUTE A COMPLETE AND UNCONDITIONAL WAIVER AND RELEASE OF ALL LIABILITY TO THE FULL EXTENT OF THE LAW. I AM EIGHTEEN (18) YEARS OF AGE OR OLDER, OR IF UNDER EIGHTEEN (18) YEARS OF AGE, CERTIFY OR REPRESENT BY MY PARENT AND/OR LEGAL GUARDIAN SIGNING THIS FORM, THAT I AM MENTALLY COMPETENT TO ENTER INTO THIS WAIVER, AND REPRESENT THAT I AM NOT CURRENTLY UNDER THE INFLUENCE OF DRUGS OR ALCOHOL, NOR WILL I ENGAGE IN ANY TRAINING ACTIVITIES UNDER THE INFLUENCE OF DRUGS OR ALCOHOL.
PARTICIPANT:
If under eighteen (18) years of age, his/her Parent or Legal Guardian must also sign below.
