In consideration of being permitted to participate in any way, including travel to and from, in any judo, kenpo, jujitsu, fencing, sambo, or martial arts fitness training session, tournament, practice, clinic, and related events and activities of Dayn DeRose, Daryn DeRose, Mark Lawrence, SOUTH MOUNTAIN MARTIAL ARTS or KORYU JUDO OF MADISON I hereby:

1. Acknowledge that I am familiar with martial arts fitness training, the sport of kenpo, judo, jujitsu, fencing, or sambo and understand the rules governing that sport or activity.

2. Agree that prior to participating, I will inspect the mats, equipment, facilities, competition pools or divisions, and the elimination or scoring system to be used, and if I believe anything is unsafe or beyond my capability, I will immediately advise my coach or supervisor of such condition(s) and refuse to participate.

3. Acknowledge and fully understand that I will be engaging in a contact sport or a fitness training activity that might result in serious injury, including permanent disability or death, and severe social and economic losses due to not only my own actions, inactions or negligence, but also to the action, inaction or negligence of others, the rules of judo, kenpo, jujitsu, fencing, sambo, or martial arts fitness training, or conditions of the premises or of any equipment used. Further, I acknowledge that there may be other risks not known to me or not reasonably foreseeable at this time.

4. Knowing the risks involved in the sport of judo, kenpo, jujitsu, fencing, or sambo, or of martial arts fitness training, I assume that risk and accept personal responsibility for the damages following such injury, permanent disability or death.

5. Release, waive and discharge and covenant not to sue Dayn DeRose, Daryn DeRose, Mark Lawrence, South Mountain Martial Arts, Koryu Judo of Madison, their affiliated clubs, their respective administrators, directors, agents, coaches, and other employees or volunteers of the organization, event officials, medical personnel, other participants, their parents, guardian(s), supervisors and coaches, sponsoring agencies, sponsors, advertisers, and, if applicable, owners, lessors, and lessees of premises used to conduct the event, all of whom are hereinafter referred to as "releasees", from any and all claims, demands, losses, or damages on account of injury including permanent disability and death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releasees or otherwise.

6. Parent(s) or legal guardian(s) of minor participants (age 18 and below) additionally agree that they will instruct the minor participant to the above warnings and conditions and their ramifications, and that they consent to the minor's participation.

I HAVE READ THE ABOVE WARNING, WAIVER AND RELEASE, UNDERSTANDING THAT I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT. AND KNOWING THIS, SIGN IT VOLUNTARILY. I AGREE TO PARTICIPATE KNOWING THE RISKS AND CONDITIONS INVOLVED AND DO SO ENTIRELY ON MY OWN FREE WILL.