ZENITH MARTIAL ARTS & LEADERSHIP ASSUMPTION OF RISKS, RELEASE OF LIABILITY, WAIVER, CONFIRMATION AND INDEMNITY AGREEMENT
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First Name: {name}
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DOB: {dob}
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Address: {address}
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Phone: {phone}
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Emergency Contact: {contact_name}
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Emergency Contact Phone: {contact_phone}
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| Relation: {contact_relation} |
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In consideration of Zenith Martial Arts and Leadership Inc. (“Zenith”) and each of its respective directors, officers, employees, sub-contractors, agents, representatives, affiliates, subsidiaries, related companies, successors and assigns (hereinafter collectively referred to as the “Releasees”) permitting the undersigned (the “Participant”) to visit, drop-in, participate in trials (which could be over multiple days), or in other martial arts activities as the case may be (the “Activities”), the Participant (if older than 18 years of age) and/or the undersigned parent/legal guardian (the “Parent”) (if under than 18 years of age) agrees as follows:
ACKNOWLEDGEMENT & ASSUMPTION OF RISKS: The Participant and/or Parent acknowledges that participation in the Activities entails foreseeable and unanticipated risks arising from Muay Thai, kickboxing, sparring, clinching, partner drills, fitness training, and related martial arts activities including from physical contact, falls, collisions with other participants and impact from equipment that could result in significant physical exertion, physical injury (including without limitation sprains, strains, concussions, head injuries, broken bones, and other serious injuries) emotional injury, paralysis, and death or damage to person, to property or to third parties. The Participant and/or Parent acknowledges that the risks cannot be eliminated despite the efforts of the Releasees to provide a safe environment and are inherent in the Activities wherein Participants intentionally receive strikes, punches, kicks, knees, elbows, clinching, and other techniques during drills, training, and sparring sessions. Notwithstanding the foregoing, the Participant and/or Parent agrees, accepts and assumes all of the risks associated with participating in the Activities even if arising from negligence, including any compounding or aggravation of injuries caused by the negligent rescue operations or procedures, of the Releasees. The Participant and/or Parent undertakes to follow, or cause to be followed, at all times, all applicable rules of Zenith and accepts that the sole responsibility for personal safety remains with the Participant and/or Parent.
MEDICAL RELEASE: The Participant and/or the Parent hereby represents, warrants and certifies that the Participant does not suffer from any physical disability or medical or emotional condition which would or could pose a risk to the Participant while participating in any of the Activities and understands that the Releasees are relying on this certification. Notwithstanding that the Releasees have no obligation to do so, the Participant and/or Parent authorizes the Releasees to provide treatment for the Participant in the event of an injury. If no medical treatment is provided, if the Participant is further injured during the medical treatment, or if the provided treatment is ineffective, the Participant and/or Parent shall not hold the Releasees liable or responsible in any way. The Participant and/or Parent shall be solely responsible for all costs of any such treatment.
RELEASE OF LIABILITY, WAIVER AND INDEMNITY: The Participant and/or Parent hereby voluntarily releases and forever discharges the Releasees from any and all liability, loss, damage, and expense they may incur for any injury whatsoever, including death, sustained by the Participant, or the family, heirs, assigns, personal representatives or estate of the Participant, and waives any claims, demands, actions, rights to sue, or causes of action of any kind they may have as a result of the Participant’s attendance or participation in the Activities due to any cause whatsoever including negligence, breach of contract, breach of any statutory or other duty of care and particularly pursuant to the Occupier’s Liability Act (R.S.O. 1990, c.O.2), and including any failure on the part of the Releasees to safeguard or protect the Participant from the risks, dangers and hazards of participating in the Activities. The Participant and/or Parent further agrees to indemnify and hold harmless the Releasees from any and all liability for injury whatsoever, including death, to the Participant and any third party, whether to property or personally, resulting from the Participant’s participation in the Activities. This agreement to indemnify and hold the Releasees harmless includes, but shall not be limited to and shall apply to, all costs, legal or otherwise, incurred in defending any such claim, demand, lawsuit, action or cause of action. The Parent further acknowledges that it is his or her sole responsibility to ensure a Participant under the age of 18 years is properly supervised and chaperoned at all times during the Activities. The Releasees have no obligation in this regard.
USE OF IMAGES OR RECORDINGS OF THE ACTIVITIES: The Participant and/or the Parent acknowledges that the Releasees may from time-to-time capture sounds and images (“electronic recordings”) at or for the Activities. The Participant and/or Parent acknowledges that the voice and image of Participant may be included in such electronic recordings and consents to the same. The Participant and/or the Parent hereby transfers and assigns to the Releasees the exclusive right to (i) make such recordings for commercial purposes which may be broadcast to the public in the sole discretion of the Releasees and generate revenue to their benefit; and (ii) to utilize electronic recordings captured at or for the Activities and including the Participant's image and/or voice for commercial purposes in perpetuity, which may be broadcast to the public in the sole discretion of the Releasees and generate revenue to their benefit. The Participant and/or the Parent waives any right to monitor, inspect or approve any such electronic recordings or the commercial use, broadcast or sale of any such electronic recordings.
GENERAL: Where the Participant is under the age of 18 years, the Parent certifies that he or she has full authority with respect to the care, control and custody of the Participant and understands that the Releasees are relying on this certification. The Participant and/or the Parent gives permission for and consents to the Participant competing in the Activities. The Participant and/or Parent consents to the collection, use and disclosure of the Participant’s personal information for the purposes of administering participation in the Activities. The Participant and/or Parent agree that: (a) if any portion of this document is, for any reason, held to be invalid, illegal or unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect the other provisions herein, and this document shall be construed as if such invalid, illegal or unenforceable portion had never been contained herein (b) the substantive law of the province of Ontario will apply regardless of the province in which the Activities take place and that any litigation will take place solely in the province of Ontario.
I HAVE READ THIS DOCUMENT THOROUGHLY. I UNDERSTAND THAT THE RELEASES ARE RELYING UPON MY ASSUMPTION OF RISKS, WAIVERS, RELEASES, UNDERTAKINGS, CONSENTS, WARRANTIES, CERTIFICATIONS AND AGREEMENTS WHEN ACCEPTING ME OR MY MINOR CHILD/WARD’S PARTICIPATION IN THE ACTIVITIES. I UNDERSTAND THAT BY SIGNING THIS DOCUMENT I GIVE UP SUBSTANTIAL LEGAL RIGHTS I WOULD OTHERWISE HAVE. I SIGN THIS DOCUMENT VOLUNTARILY AND WITHOUT INDUCEMENT.
Date Signed: {sign_date}
