UNLIMITED POSSIBILITIES MARTIAL ARTS AND FITNESS, LLC
RELEASE OF LIABILITY AND ASSUMPTION OF RISK
I, the “Participant” (and on behalf of my child(ren) participating in the Activity, if this Release is executed on behalf of a Participant under the age of 18), desire to participate in certain martial arts and related fitness activities (the “Activity”) provided by Unlimited Possibilities Martial Arts and Fitness, LLC, a California limited liability company (“UPMAF”). In consideration of participating in the Activity and in recognition of UPMAF’s reliance hereon, I agree, on behalf of myself, my heirs, and my personal representatives, to all the terms and conditions set forth in this instrument (this “Release”).
I AM AWARE AND UNDERSTAND THAT THE ACTIVITY IS A POTENTIALLY DANGEROUS ACTIVITY AND INVOLVES THE RISK OF PERSONAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, TEMPORARY OR PERMANENT DISABILITY, DEATH, PROPERTY DAMAGE, AND/OR FINANCIAL LOSS. I ACKNOWLEDGE THAT ANY INJURIES THAT PARTICIPANT SUSTAINS MAY RESULT FROM OR BE COMPOUNDED BY THE ACTIONS, OMISSIONS, OR NEGLIGENCE OF UPMAF, INCLUDING NEGLIGENT EMERGENCY RESPONSE OR RESCUE OPERATIONS OF UPMAF. NOTWITHSTANDING THE RISK, I ACKNOWLEDGE THAT I AM KNOWINGLY AND VOLUNTARILY PARTICIPATING IN THE ACTIVITY WITH AN EXPRESS UNDERSTANDING OF THE DANGER INVOLVED AND HEREBY AGREE TO ACCEPT AND ASSUME ANY AND ALL RISKS OF INJURY, DISABILITY, DEATH, OR PROPERTY DAMAGE ARISING FROM PARTICIPATION IN THE ACTIVITY, WHETHER CAUSED BY THE ORDINARY NEGLIGENCE OF UPMAF OR OTHERWISE.
I hereby expressly waive and release any and all claims which I may have, or which I may hereafter have, whether known or unknown, against UPMAF, and its officers, directors, managers, employees, agents, affiliates, shareholders/members, successors, and assigns (collectively, “Releasees”), on account of injury, disability, death, or property damage arising out of or attributable to my participation in the Activity, whether arising out of the ordinary negligence of UPMAF or any Releasees or otherwise. I covenant not to make or bring any such claim against UPMAF or any other Releasee, and forever release and discharge UPMAF and all other Releasees from liability under such claims. This waiver and release does not extend to claims for gross negligence, intentional or reckless misconduct, or any other liabilities that California law does not permit to be released by agreement.
I understand that by signing this release, I, for myself and on behalf of Participant, am waiving any and all claims, of any kind arising out of or attributable to participation in the Activity, including those claims that may be unknown to me, or which I do not suspect to exist at this time. WITH THE INTENTION OF WAIVING ALL UNKNOWN AND UNSUSPECTED CLAIMS, I HEREBY EXPRESSLY WAIVE ALL RIGHTS, BENEFITS, AND PROTECTIONS I MAY HAVE UNDER CALIFORNIA CIVIL CODE SECTION 1542, WHICH READS AS FOLLOWS:
A general release does not extend to claims that the creditor or releasing party does not know or suspect to exist in his or her favor at the time of executing the release and that, if known by him or her, would have materially affected his or her settlement with the debtor or released party.
I shall defend, indemnify, and hold harmless UPMAF and all other Releasees against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, including reasonable attorney fees, fees, the costs of enforcing any right to indemnification under this Release, and the cost of pursuing any insurance providers, incurred by UPMAF or any other Releasees, arising out of or resulting from any claim of a third party related to Participant’s participation in the Activity, including any claims arising out of my own negligence or the ordinary negligence of UPMAF.
I hereby consent to receive from any licensed hospital, physician, or medical personnel any medical treatment deemed necessary if I am injured or require medical attention during my participation in the Activity. I understand and agree that I am solely responsible for all costs related to such medical treatment and any related medical transportation and/or evacuation and I release all parties from any type of liability for anything that may happen during my treatment.
This Release constitutes the sole and entire agreement of UPMAF and Participant with respect to the subject matter contained herein and supersedes all prior and contemporaneous understandings, agreements, representations, and warranties, both written and oral, with respect to such subject matter. If any term or provision of this Release is held invalid, illegal, or unenforceable in any jurisdiction, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this Release or invalidate or render unenforceable such term or provision in any other jurisdiction. This Release is binding on and shall inure to the benefit of UPMAF and Participant and our respective heirs, successors, and assigns. All matters arising out of or relating to this Release shall be governed by and construed in accordance with the internal laws of the State of California without giving effect to any choice or conflict of law provision or rule (whether of the State of California or any other jurisdiction). Any claim or cause of action arising under this Release may be brought only in the federal and state courts located in Orange County, California and I hereby consent to the exclusive jurisdiction of such courts.
BY SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ AND FULLY UNDERSTOOD ALL OF THE TERMS OF THIS RELEASE AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE UPMAF FOR CLAIMS, WHETHER KNOWN OR UNKNOWN, ARISING OUT OF PARTICIPATION IN THE ACTIVITY. I AM AT LEAST EIGHTEEN (18) YEARS OF AGE OR AM THE PARENT OR LEGAL GUARDIAN OF A PARTICIPANT UNDER THE AGE OF 18 AND HAVE THE LEGAL RIGHT TO CONSENT, AND FULLY COMPETENT.
I certify that the Participant is physically fit and has no medical condition that would make participation in the Activity more hazardous. I SPECIFICALLY ACKNOWLEDGE AND CERTIFY that, if Participant has down syndrome, Participant has undergone a full radiological examination and certifies the absence of Atlanto-Axial instability as a prerequisite to participating in the Activity.
If the Participant is under the age of 18, a parent or legal guardian must sign this form.
Participant's Name:
Parent/Guardian Name of Participant (put N/A in both fields if this does not apply):
Signature: