Consent & Injury Waiver
By signing at the bottom of this form you are agreeing and giving consent to the following terms:
• I understand that 4 Week Trial Programs are subject to expire if not in use within 30 days of payment and that the weeks must be consecutive.
• I understand that 3 Class Trial Programs are subject to expire if not in use within 2 week time period of payment.
• I give my consent to Next Evolution Martial Arts for the use of any photographs or videos taken of myself and or my child during classes, events or tournaments for any lawful purpose including social media, advertising, website and web content. I
understand that I may revoke this authorization at any time by notifying management.
Injury Waiver
In consideration of being allowed to participate in any way at Next Evolution Martial Arts Academy programs or it’s related to events and activities, I the student or the parent of the student acknowledge, appreciate and agree that:
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1) The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis
and death, and while particular skills, equipment, and personal discipline may reduce this risk the risk of serious injury does
exist; and,
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2) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE
ORDINARY NEGLIGENCE OF THE RELEASEES, AGENTS, EMPLOYEES or others, and assume fill responsibility for
my participation OR MY CHILD’S PARTICIPATION: and,
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3) I willingly agree to comply with the stated and customary terms and conditions for participation. If however, I observe any
unusual significant hazard during my presences or participation, I will remove myself from participation bring such to the attention of the Company immediately; and, understanding that this at times maybe a contact activity, such as football, soccer, wrestling and other sports, I acknowledge that there is a possibility of injury as in any other contact sport.
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4) I, for myself AND my child, and on behalf of my heirs, assigns, personally representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS Mullero Kaizen Do LLC, their officers, (dba) Next Evolution Martial Arts Academy agents and/or employees, other participants, owners and lesser of premises used for the activity (“releases”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE, RECKLESSNESS OR INTENTIONAL ACTS OF THE RELEASES OR OTHERWISE, to the fullest extent permitted by law. I the undersigned, and by signing of this waiver assume fill responsibility for any injury that may occur.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHT BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. I REPRESENT AND WARRANT TO THE COMPANY THAT I HAVE THE AUTHORITY TO SIGN THIS RELEASE BOTH FOR MYSELF AND AS A PARENT AND GUARDIAN OF MY CHILD, THE STUDENT.