Ninja Waiver

Name *

First Name Last Name

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Email *

example@example.com

List Name of Children Participating if Applicable

Ninja Liability Waiver I acknowledge that the activity (ninja, rock climbing, competition and exercise of any kind) I am to undertake is a dangerous activity and that by participating in it, I am exposed to certain risks. I am responsible to consult with my physician before engaging in exercise or any other type of physical activity. I acknowledge and understand that whilst participating in such activities: My personal property may be lost or damaged, Other persons participating in such activity may cause me injury or may damage my property, I may cause injury to other persons or damage their property, the conditions in which the activity is conducted may vary without warning, there may be no or inadequate facilities for treatment or transport of me if I am injured. I may not use property, equipment, objects, obstacles, or structures, man-made and/or natural, for activities other than their intended uses in accordance to Illumination Training Center, LLC intended uses. Illumination Training Center, LLC is not responsible in any way for any injury, loss, damage or death caused to myself or my property as a result of any type of equipment failure. Illumination Training Center, LLC is not responsible in any way for any injury, loss, damage or death caused to myself or my property as a result of any type of equipment failure. I assume the risk and responsibility for any injury, death, or property damage resulting from my participation in the activity at Illumination Training Center or at an off site event where Illumination Training Center has set up a ninja course; I participate in the activity at my sole risk and responsibility. I release, indemnify and hold harmless Illumination Training Center, LLC its servants and agents, from and against all and any actions or claims which may be made by me or on my behalf or by other parties for or in respect of or arising out of any injury, loss, damage or death caused to me or my property whether by negligence, breach of contract or in any way whatsoever. I grant exclusive permission to Illumination Training Center, LLC its servants and agents to use my name, likeness, videos, and photographs for the purpose of publicity, public relations, or other advertising purposes without restriction as to frequency or duration. By submitting this form, I agree to above started and release Illumination Training Center (ITC NINJAS) from any liability for myself or my child. Please list any health concerns we should be aware of.

Signature *

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Date *

Date