Hercules Krav Maga Liability Waiver

First Name*
Last Name*
Phone Number*

Area CodePhone Number
Email*
example@example.com
Are you 18 years or older?

YESNO
What is your birthday? We love to celebrate with happy wishes! Please list the month and day:
What are your expectations in learning Krav Maga? Please share what specific skills or areas you are most interested in learning or improving:
I understand that if I need to leave class early, I will inform the instructor prior. It's important that we accommodate your timeline and adjust any teachings so that you experience a well-rounded foundational self-defense class.*
Instructor Ari and all Hercules Krav Maga and AriFit Wellness instructors are trauma-informed. I also understand that Krav Maga training is physical and involves realistic simulation scenarios, techniques, and stress drills. I acknowledge that I may experience fight, flight, or freeze responses during self-defense training. I ACCEPT THESE POTENTIAL RISKS AND TRUST MYSELF TO OPT OUT OF ANY TRAINING DRILLS THAT I MAY NOT FEEL READY FOR.*
Knee compression sleeves and non-slip shoes are mandatory for class. Please ensure that you have these items before attending to ensure safety and comfort during training.

Please answer the questions below.

Type 'yes' if you agree, or describe why you chose 'NO', if applicable.
I understand that Krav Maga self-defense training involves close contact with other participants, and I am aware that this may include physical interactions such as holds, strikes, and defensive techniques.
Please describe your level of comfort with UNMASKED training. This includes your comfort with the possibility of being in close proximity to others without wearing a mask during class sessions:
I confirm that I will attend the entire class session. If, for any reason, I am unable to stay for the full duration, I will notify my instructor in advance.
Please indicate if you are attending a specific solo workshop. If so, kindly list the name and date of your scheduled class/workshop:
Every class is $25 for drop-in attendance. [For those training at our Soledad location: A package of 10 classes is $197, OR ONE (1) YEAR of unlimited training is $997]*
I understand that bruises, cuts, and light-to-medium contact are a natural part of the realistic training process in class. I ACKNOWLEDGE THAT IT IS MY RESPONSIBILITY TO COMMUNICATE WITH MY TRAINING PARTNER IF THE DRILL OR TRAINING BECOMES TOO TOUGH. If my partner does not lower their intensity, I will inform my instructor.*

- I WILL NOT USE MY HAND TO COUGH OR SNEEZE.
- I acknowledge the contagious nature of Coronavirus/COVID-19, and that the CDC and other public health authorities continue to recommend practicing social distancing. I further acknowledge that AriFit Wellness Education & Hercules Krav Maga have implemented best practices to place preventative measures in place to reduce the spread of the Coronavirus/COVID-19.
- However, I understand that AriFit Wellness Education & Hercules Krav Maga cannot guarantee that I will not become infected with the Coronavirus/COVID-19. I acknowledge that the risk of becoming exposed to and/or infected by Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, staff, clients, or their families.
- I voluntarily seek services provided by AriFit Wellness Education & Hercules Krav Maga and acknowledge that I am increasing my risk of exposure to the Coronavirus/COVID-19. I agree to comply with all set procedures to reduce the spread while attending my appointment.
I attest that:

- I am not experiencing any symptoms of illness, including cough, shortness of breath, difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
- I have not traveled internationally within the last 14 days.
- I have not traveled to a highly impacted area within the United States of America in the last 14 days.
- I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.
- I have not been diagnosed with Coronavirus/COVID-19 and have not yet been cleared as non-contagious by state or local public health authorities.
- I am following all CDC-recommended guidelines to limit my exposure to the Coronavirus/COVID-19.
AGREE*

Yes

Photo/Video Release
- I hereby grant AriFit Wellness Education & Hercules Krav Maga permission to use my likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration. I understand and agree that all photos will become the property of AriFit Wellness Education and Hercules Krav Maga and will not be returned.
- I hereby irrevocably authorize AriFit Wellness Education & Hercules Krav Maga to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears.
- Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo.
- I hereby hold harmless, release, and forever discharge AriFit Wellness Education and Hercules Krav Maga from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.
I HAVE READ AND UNDERSTAND THE ABOVE PHOTO RELEASE. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENTS/GUARDIANS AS EVIDENCED BY THEIR SIGNATURES BELOW.

I ACCEPT:
AGREE

YesI would like any photos of myself to be redacted. I WILL ALSO TELL ARI, ANY INSTRUCTORS, & ALL PHOTOGRAPHERS THAT I NEED MY PHOTOS REDACTED.

- I hereby release and agree to hold Arielle/Ari & AriFit Wellness Education & Hercules Krav Maga harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the business, or that may otherwise arise in any way in connection with any services received from AriFit Wellness Education/Hercules Krav Maga.

- I understand that this release discharges AriFit Wellness Education and Hercules Krav Maga from any liability or claim that I, my heirs, or any personal representatives may have against the services with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from AriFit Wellness Education/Hercules Krav Maga.

- This liability waiver and release extends to the services & training together with all owners, partners, and employees.

- I recognize that the program may involve strenuous physical activity including, but not limited to, muscle strength and endurance training, cardiovascular conditioning and training, and other various fitness activities. I hereby affirm that I am in good physical condition and do not suffer from any known disability or condition which would prevent or limit my participation in this exercise program. I acknowledge that my enrollment and subsequent participation is purely voluntary.

- I fully understand that I may injure myself as a result of my enrollment and subsequent participation in this program and I hereby release Arielle Kantor and any/all AriFit Wellness Education/Hercules Krav Maga assistants or instructors from any liability now or in the future for conditions that I may obtain.

- I affirm that I have stated all my known medical conditions, and answered all questions honestly. I agree to keep the trainer updated as to any changes in my medical profile, and understand that there shall not be liability on the instructor’s part should I forget to do so.

- I understand that the training I receive is provided for the purpose of exercise instruction and self-defense guidance. I further understand that trainers are not qualified to perform, diagnose, prescribe, or treat any physical or mental illness, provide nutritional planning, and that nothing said in the course of the session(s) given should be considered as such. I should see a physician, chiropractor, registered dietitian or other qualified medical specialist for any nutritional concerns, mental or physical ailment that I am aware of.
Name

First NameLast Name
Date

MonthDayYear
Date
Signature*

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In the EVENT OF AN EMERGENCY, CONTACT: (name/phone number/association)*
If under 18, A PARENT/GUARDIAN MUST SIGN

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Date

MonthDayYear
Date
I accept that Krav Maga training carries inherent risk of injury, and I participate at my own risk. I also understand that bruising, falling, and scratches are common occurrences in physical defense training, and I attend all classes with this awareness and understanding.*
I acknowledge that if a training partner's level of physical ability is unsuitable for me, I will first communicate with my partner and secondly notify my instructor if I need a partner change.*
To ensure a HYGIENIC training environment, it's essential to prioritize cleanliness, especially during close-contact activities like AriFit/Hercules Krav Maga training. If you happen to sneeze or cough into your hands, please sanitize yourself immediately. This simple yet important measure helps maintain the health and well-being of everyone participating in our sessions.*
By participating in AriFit/Hercules Krav Maga classes, workshops and self-defense training, I acknowledge and accept the inherent risks involved. I hereby release AriFit/Hercules Krav Maga and all individuals associated, its employees, volunteers, agents, and representatives from any liability, claims, damages, injuries, or losses that may arise as a result of my participation. I understand that it is my responsibility to ensure my own safety and well-being during all AriFit Wellness/Hercules Krav Maga training sessions, and I agree to abide by all rules and instructions provided by the instructors and organizers.*
Additional Concerns: Is there anything specific you'd like to learn to defend against? Do you have any physical limitations or injuries that you'd like to remind us of? If desired, please also list your preferred pronouns:*
Payment Confirmation: I confirm that I have paid in advance for my classes through the following payment options: www.arifit.com/thankyou.*
Ari & Hercules Krav Maga instructors reserve the right to remove anyone from class or training sessions at their discretion.
please type your name
VERIFICATION: I verify that everything in this waiver is correct.*

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