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MAD ROCK MARTIAL ARTS & FITNESS
LIABILITY WAIVER AND RELEASE FORM
Participant Name:
____________________________________
Date of Birth: ______ / ______ / ______
Parent/Guardian (if under 18): ____________________________________
Phone Number: _______________________
Email: ____________________________
1. Acknowledgment of Risk
I understand and acknowledge that participation in martial arts, fitness training, and related physical activities at Mad Rock Martial Arts & Fitness involves inherent risks of injury, including but not limited to: physical exertion, contact with other participants, use of equipment, and participation in drills or sparring. These activities may result in serious injury or even death.
2. Assumption of Risk
I voluntarily choose to participate in these activities and assume all risks associated with my participation, whether known or unknown to me at this time. I certify that I am physically fit and have no medical condition that would prevent my safe participation.
3. Release of Liability
In consideration for being allowed to participate, I hereby release, waive, and discharge Mad Rock Martial Arts & Fitness, its owners, instructors, employees, volunteers, agents, and affiliated organizations from any and all liability, claims, demands, actions, or causes of action resulting from any damage, injury, or death arising from participation or attendance in classes or events at the facility.
4. Medical Consent
In the event of an emergency, I authorize Mad Rock Martial Arts & Fitness to obtain medical treatment for myself or my child, as applicable. I understand that I am responsible for all costs related to such treatment.
5. Photography & Media Release
I grant permission for Mad Rock Martial Arts & Fitness to use photographs and video recordings of me (or my child) taken during classes or events for promotional purposes, including social media, websites, and printed materials.
6. Rules & Conduct
I agree to abide by all facility rules and the instructions of the staff. I understand that failure to follow safety guidelines may result in suspension or termination of participation without refund.
7. Minors
If the participant is under 18 years of age, I certify that I am the parent or legal guardian and I agree to the terms on their behalf.
Participant Signature:
____________________________ Date: ______ / ______ / ______
Parent/Guardian Signature (if under 18): ____________________________ Date: ______ / ______ / ______
