KICKSIDE LIABILITY WAIVER

Parent / Guardian Contact Information

Full Name

Phone *

Email *

Address *

City *

State *

Student / Participant Information

Participant name *

Event Type *

General Liability & Waiver

Liability Waiver *

I, the undersigned, am the parent or legal guardian of the above-named minor ("Participant"). In consideration of the Participant being allowed to participate in any way in the martial arts program, related events, and activities of Kickside Martial Arts, the undersigned acknowledges, appreciates, and agrees that:

Assumption of Risk: I am fully aware that martial arts involves risks and dangers, including but not limited to physical injury, psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis), and/or death, which may be caused by the Participant’s own actions or inactions, those of others participating in the activity, the conditions in which the activity takes place, or the negligence of the "Releasees" named below.
Release and Waiver: I, for myself, the Participant, and on behalf of our heirs, assigns, personal representatives, and next of kin, hereby release, indemnify, and hold harmless Kickside Martial Arts, its officers, officials, agents, and/or employees, other participants, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (collectively "Releasees"), with respect to any and all injury, disability, death, or loss or damage to person or property, whether caused by the negligence of the Releasees or otherwise.

Medical Treatment: I hereby authorize Kickside Martial Arts to act on my behalf in seeking and approving medical treatment in the event of an emergency. I further agree to pay any costs associated with medical care and transportation for the Participant.

Photo & Video Release

I hereby grant to Kickside Martial Arts the absolute and irrevocable right and unrestricted permission concerning any photographs, videos, or audio recordings that Kickside Martial Arts has taken or may take of the Participant or in which the Participant may be included with others, to use, reuse, publish, and republish the same in whole or in part, individually or in conjunction with other photographs, videos, or audio recordings, and in any medium and for any purpose whatsoever, including (but not by way of limitation) illustration, promotion, advertising, and trade, and to use the Participant’s name in connection therewith. I hereby release and discharge Kickside Martial Arts from any and all claims and demands arising out of or in connection with the use of the photographs, videos, or audio recordings, including without limitation any and all claims for libel or violation of any right of publicity or privacy.

I have read this release of liability and assumption of risk agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.

Signature

Clear