KMG USA Waiver, Release, Hold Harmless and Indemnification Agreement, Authorization to Use Pictures and Video Images.
In exchange for participation and/or allowance to enter the training area and/or participate in any program at any Krav Maga Global USA Facility, Affiliate Location and/or Event otherwise known as KMG USA, the undersigned, on his or her behalf, and on the behalf of the Participant(s) identified below, acknowledges, appreciates, understands and agrees to the following:
1) I represent that I (we are) am the Participant(s) named below to execute this agreement.
2) I agree to observe and obey all posted rules and warnings and further agree to follow all oral instructions or directions given by KMG USA, or the employees, representatives or instructors of KMG USA.
3) I acknowledge and understand that there are risks associated with participation in KMG USA activities and the use of training area and equipment including, but not limited to: contusions, fractures, scrapes, cuts, bumps, paralysis or death.
4) I, for myself and the Participant(s) named, willingly assume the risks associated with participation and accept that there are also risks that may arise due to OTHER PARTICIPANTS in which I also willingly assume.
5) I, for myself, the Participant(s) named, our heirs, assigns, representatives and next of kin agree to hold harmless and Indemnify the independent owner(s) of any KMG USA facility/event , VACCA MMA and Fitness Inc., the Parent Organization Krav Maga Global, their predecessors, parent, subsidiaries and affiliates, officers, and employees for any defense cost or expense arising from any and all claims, injuries, liabilities or damages arising from participation.
6) I additionally agree to indemnify the independent owner of any KMG USA facility/event, VACCA MMA and Fitness Inc., the Parent Organization Krav Maga Global their predecessors, parent, subsidiaries and affiliates, officers, and employees for any defense cost or expense arising from any claims, injuries, liabilities or damages arising from participation.
7) I agree to pay for all damages to the facilities of KMG USA caused by my negligent, reckless, or willful actions.
8) Any legal or equitable claim that may arise from participation in the above shall be resolved under Pennsylvania law.
9) I authorize KMG USA to use any and all pictures or video images were taken or filmed of me during any ays activity. I understand and accept that said pictures or images may be published, including posting to the internet, and acknowledge that I am not entitled to any form of compensation or damages whatsoever relative to said pictures or images.
10) I avow any Participant(s) named are of physical ability to participate, and I and Participant(s) named are legally competent to understand and complete this agreement. I hereby execute this agreement without coercion.
11) To help ensure the safety of our students and to maintain the proper culture of our dojo, students must wear KMG USA approved attire and MUST train with approved KMG USA training equipment.
12) I acknowledge the existence of certain inherent risks in the type of training and hereby agree to assume all risks. I further relieve the studio, it's management, assigned staff, and fellow students from any liability resulting from personal injury or loss of personal belongings. I also hereby state that the students named above are physically fit to take the prescribed course of instruction and do so of their own free will for an agreed-upon fee. I understand there is no refund policy on any monies I will pay KMG USA.
13) As Parent and/or Guardian of the named participant, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.
Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.
Permission is also granted to KMG USA and its affiliates including Directors, Coaches, and Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.
I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS. BY ACKNOWLEDGING AND CLICKING "I ACCEPT THE ABOVE TERMS" AND/OR "SUBMIT FORM," I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.