Waiver/Release of Liability

Name *
Name
Phone
Phone
Date of Birth
Date of Birth
AGE VERIFICATION *
I agree that I am 18 years of age, or older. If under 18 you must have a parent/guardian agree to the below terms and consent for you to engage in any activities at Nor'easter Martial Arts, LLC, dba Randy Brown Mantis Boxing.
TERMS/CONDITIONS *
Nor'easter Martial Arts, LLC reserves the right to dismiss any student due to misconduct, failure to obey rules or policies, disruptive behavior, or any other violation of Nor'easter Martial Arts, LLC policy. I agree to join Nor'easter Martial Arts, LLC under all of the terms and conditions set forth on this application and included in the school policies.
RELEASE OF LIABILITY IN CASE OF INJURY *
I understand that classes at Nor'easter Martial Arts, LLC may be physically strenuous, and I voluntarily participate in them with full knowledge that this involves the risk of all types of personal injury, property loss, or death. I understand that it is my responsibility to consult a physician before beginning my training. I also understand that it is my responsibility to provide the proper equipment for my activities at Nor'easter Martial Arts, LLC, and my responsibility to maintain my equipment in safe operating condition. I am also responsible for any medical expenses I incur as a result of my training at Nor'easter Martial Arts, LLC. I agree to release Nor'easter Martial Arts, LLC, its officers, agents, and employees from any and all liability arising from any loss, damage, injury or cause of action resulting from my participation in Nor'easter Martial Arts, LLC classes, competitions, or events, or in traveling to or from classes, practices, competitions, events and social activities. This promise extends to liability arising from negligence of Nor'easter Martial Arts, LLC, its officers, agents, and employees, and any other cause. I further agree, for myself, my heirs, executor, or administrator, to indemnify Nor'easter Martial Arts, LLC and its officers, agents and employees and hold them harmless from any such liability, claims, demands or causes of action.
APPLICANTS UNDER 18 *
As a parent or guardian responsible for my minor child, I understand that enrolling my child in a martial arts program involves some risk of injury, including serious or disabling injuries, or death. I understand that in enrolling my child in classes at Randy Brown Mantis Boxing, the release above applies to actions arising from injuries, losses, or damage to my child. I consent to my child’s participation in Nor'easter Martial Arts, LLC, dba Randy Brown Mantis Boxing. Furthermore, if I cannot be contacted in the event of a medical emergency requiring immediate attention, I hereby consent to allow Nor'easter Martial Arts, LLC to take action to place this applicant into the care of a qualified healthcare professional and/or an appropriate medical treatment authority or facility, and do hereby release Nor'easter Martial Arts, LLC , its principals, instructors, and others associated with Nor'easter Martial Arts, LLC from any and all liability for any consequence arising from such action.
By typing my name below, I agree to the terms and conditions, release of liability stated above.