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Mentality Martial Arts

RELEASE AND WAIVER OF LIABILITY AND HOLD

HARMLESS AGREEMENT

In consideration of being permitted to participate in or assisting others in participating in the activities at Mentality Sports LLC. DBA Mentality Martial Arts (hereinafter “Mentality"), and related events and/or activities, on behalf of myself, or a minor child or ward, heir, next of kin, personal representative, successor or assign;

1. I {name}, ACKNOWLEDGE, UNDERSTAND, DECLARE AND AGREE THAT:

(a) To the best of my knowledge, I am in good physical condition and have no disease or injury that would be aggravated by participating in activities at Mentality;

(b) Participating or assisting others in participating at Mentality may involve RISK OF INJURY TO ME, INCLUDING DEATH, LOSS OR DAMAGE TO ME OR MY PROPERTY, or other consequences, which might result not only from my own actions, inaction or negligence but also the actions, inaction or negligence of others, or the conditions of the premises or of any equipment used;

(c) There may be OTHER RISKS not known or not reasonably foreseeable; and understanding all of the above,

2. I ASSUME ALL OF THE ABOVE RISKS AND RELEASE, WAIVE, DISCHARGE, HOLD HARMLESS, INDEMNIFY AND COVENANT NOT TO SUE:

(a) Mentality, its employees or volunteers, coaches, trainers, or anyone affiliated with same, or other participants involved in the activities or not;

(b) Any affiliated subsidiary, successor, organization, or related companies or businesses, other participants, participating or sponsoring schools, agencies, international organizations, sponsors, or advertisers; and their respective administrators, officers, directors, agents, representatives, employees or volunteers of such entities or organizations, the successors, heirs, assigns, or the insurers or representatives, be it personal or business, of each aforementioned individual;

(C) Owners, lessors and lessees of the premises used to conduct the activities FROM ANY AND ALL LIABILITY FOR INJURY, INCLUDING DEATH, LOSS OR DAMAGE TO PERSON OR PROPERTY, OR ANY OTHER CONSEQUENCE in connection with entry in or arising out of participation in, performance in or lack of performance in such activities at Mentality.

3. I FURTHER AGREE THAT:

(a) Prior to participating as a participant, I, or in the case of a minor, a parent or guardian, will INSPECT the facilities and equipment to be used, and if I believe same to be unsafe, I will immediately REPORT such condition(s) to the supervisor, trainer, or official connected with Mentality of same and either DECLINE TO PARTICIPATE or ASSUME THE RISK of participating;

(b) I will ALLOW my PHOTOGRAPH, PICTURE or LIKENESS and/or VOICE to APPEAR in any official documentary, promotional (including any and all advertisements), television, and radio or film coverage of the activities at Mentality, WITHOUT COMPENSATION.

4. I CONSENT TO ALL EMERGENCY MEDICAL TREATMENT AS MAY BE DEEMED APPROPRIATE UNDER EXISTING CIRCUMSTANCES BY MEDICAL PERSONNEL OR PERSONNEL ASSOCIATED WITH Mentality.

Participant Name -
Parent Name (Submit "N/A" if over 18) -

I HAVE READ THIS FORM IN ITS ENTIRETY AND HAVE PROVIDED

TRUTHFUL INFORMATION.

All participants must complete the Release and Waiver of Liability and Hold Harmless Agreement in order to participate, exercise, work out, and/or compete at Mentality.