Temple MMA

Temple MMA
Name

First NameLast Name
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Are you 18 years or older?

Informed consent and liability waiver for participation in the exercise program. Mixed martial arts (MMA) & Fitness workout.

I accept and consent to the following:
I am voluntarily participating in the
exercise/fitness program performed by temple MMA.

I acknowledge that the program requires physical exertion that can be strenuous at times and may cause physical injury and I am fully aware of the risks and dangers involved.
I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the above named program. I represent and warrant that I do not have any medical condition that would prevent me from participating in the program.
I agree to assume full responsibility for any known or unknown risks, injuries, or damages that I may incur as a result of participating in the program. Such injuries may include, but are not limited to, heart attacks, muscle strains, pulled muscles, muscle tears, broken bones, leg cramps, heat exhaustion, knee injuries, back injuries, foot injuries, or any other illness. or pain. , including death.
I knowingly, voluntarily and expressly waive any claim I may have against the Temple MMA for injuries or damages I may suffer as a result of participating in the program.
I, my heirs or representatives forever waive, discharge and agree not to sue Temple MMA pfor any injury or death caused by their negligence or other acts.
I have read the above disclaimer and release and fully understand its contents. I voluntarily accept the terms and conditions set forth above.
AGREE

Photo/Video Release

I hereby grant the The Company 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 the The Company and will not be returned.

I hereby irrevocably authorize the The Company 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 the The Company 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

Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
If under 18, A PARENT/GUARDIAN MUST SIGN
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: