Waiver


 

I, the above named participant, hereby declare that I have been informed of the inherent dangers involved in engaging in Martial Arts and related activities, I fully realize and clearly understand that I am placing myself in danger of possible bodily injury. It is with full realization and clear understanding of the aforementioned dangers that I agree to become a participant in these activities and hereby agree to the following terms as a condition for participation: That during and all times that I am a participant in Martial Arts and any related activities. I shall be liable for any and all injuries I sustain or incur during and related to participation in Martial Arts the course of instruction, preliminary exercise, and related activities and will not hold, the sponsor(s), its governing body(ies), officials, employees and members, either individually or otherwise, liable for any such injuries or any loss or damages arising there from. I also realize that I am responsible for providing my own medical insurance or medical coverage, any and all medical expenses I might incur in participating in these activities.


That I, intending to be legally bound, hereby for myself, my heirs, executors, and administrators, waive and release any and all rights to damages or claims I have against the sponsor(s), its governing body(ies), officials, employees and members, either individually or otherwise, for injuries or rights to damages suffered by me, directly or indirectly, including any future psychological and/or physical pain and suffering claims, as a result of attending, participating in, practicing for, traveling to or from such activity, or against the owners, organizations, governing body(ies), employees, members of instructor(s), either individually or otherwise, of the gymnasium, Dojang, school, or place where held.


That I also agree to defend, indemnify, and hold the sponsor(s), it's governing body(ies) or employees, or the instructors of the program, either individually or otherwise, harmless from any claim and action by third parties alleging injury from my use of the techniques and skills learned during and related to the course of instruction, preliminary exercises, and related activities.


That I have consulted with my physician and that I am in proper health and physical condition to participate in the activities listed above.


That I further agree to follow all the rules and instructions as stated by the staff/instructors in the facility.


That I waive any and all rights to compensation, in any form, for pictures, films, or videotapes taken of me in the above activity and grant permission for them to be used for any publicity or publication purposes. I further agree that the execution of this agreement is consideration, in part, for participating in Martial Arts. I understand that my failure to execute this agreement would result in my not being able to participate in such activities, preliminary exercises, and related activities conducted by the instructor/staff of this program through the sponsoring agency.


Checkmat Valencia, LLC administrators, employees, instructors and/or coaches may make any modifications in the class schedule as deemed necessary. Such modifications do not relieve the student of their payment obligations under any circumstances.


Checkmat Valencia, LLC and those acting under its authority reserve the right to use photographs, videotapes, artwork or other likenesses of the student for marketing, trade, publishing or any other lawful purpose.


Children must remain in the spectator area and seated in the chairs while classes are in session unless they are attending a class. Children are not allowed around the heavy equipment including but not limited to the exercise equipment unless supervised by a member of the Checkmat Valencia staff. It is the responsibility of the parents to make sure their child follows the rules and regulations of Checkmat Valencia to ensure their safety at all times. In consideration of the Martial Arts training obtained, the student agrees not to engage in martial arts teaching practices for profit within a 10 mile radius of the location where classes are being conducted by Checkmat Valencia for a period of 1 year following disassociation with Checkmat Valencia, without written permission.


Student represents that (s)he is in good physical condition, is not suffering from any bodily ailment and is in all respects physically fit to engage in the martial arts course.


Physical contact will be used by administrators, employees, instructors and/or coaches of the school, other students, and authorized individuals as part of the course or instruction. Student has been advised of such fact and gives full consent to any physical contact as may be required or customary to martial arts training.


In recognition of the possibility of accident, injury or death connected with martial arts training, student waives any right or cause of action of any kind arising as the result of such activity from which any liability may or could accrue to the school, its employees, instructors and/or students.


This agreement is to remain in effect until revoked in writing and such written revocation is delivered to Leka Vieira Brazilian Jiu-Jitsu LLC or its authorized representative.

Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19

The novel coronavirus, COVID-19,has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.


CHECKMAT VALENCIA LLC (DBA CHECKMAT VALENCIA BRAZILIAN JIU-JITSU) has
put in place preventative measures to reduce the spread of COVID-19;however, CHECKMAT VALENCIA BRAZILIAN JIU-JITSU cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending the class could increase your risk and your child(ren)'s risk of contracting COVID-19.
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By signing this agreement, you acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that you or your child(ren) may be exposed to or infected by COVID-19 by attending CHECKMAT VALENCIA BRAZILIAN JIU-JITSU and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at CHECKMAT VALENCIA BRAZILIAN JIU-JITSU may result from the actions, omissions, or negligence of myself and others, including, but not limited to its owners, instructors and program participants and their families.


I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability and death), illness, damage, loss, claim, liability or expense, of any kind, that I or my child(ren) may experience or incur in connection with my attendance at CHECKMAT VALENCIA BRAZILIAN JIU-JITSU or participation in their programs ("Claims"). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless CHECKMAT VALENCIA BRAZILIAN JIU-JITSU, it's employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of CHECKMAT VALENCIA BRAZILIAN JIU-JITSU, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Club program.

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Signature Certificate
Document name: Waiver
lock iconUnique Document ID: 48f82129c96418800638b5fd79b79a9c778d88bb
Timestamp Audit
March 26, 2021 1:38 pm PDTWaiver Uploaded by Art Jamgochian - art@checkmatvalencia.com IP 172.117.173.223
March 29, 2021 11:56 am PDTArt J - checkmat.valencia@gmail.com added by Art Jamgochian - checkmat.valencia@gmail.com as a CC'd Recipient Ip: 172.117.173.223
March 29, 2021 1:18 pm PDTArt J - checkmat.valencia@gmail.com added by Art Jamgochian - checkmat.valencia@gmail.com as a CC'd Recipient Ip: 172.117.173.223
March 29, 2021 1:20 pm PDTArt J - checkmat.valencia@gmail.com added by Art Jamgochian - checkmat.valencia@gmail.com as a CC'd Recipient Ip: 172.117.173.223
March 29, 2021 1:29 pm PDTArt J - checkmat.valencia@gmail.com added by Art Jamgochian - checkmat.valencia@gmail.com as a CC'd Recipient Ip: 172.117.173.223
March 29, 2021 1:34 pm PDTArt J - checkmat.valencia@gmail.com added by Art Jamgochian - checkmat.valencia@gmail.com as a CC'd Recipient Ip: 172.117.173.223
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March 29, 2021 1:43 pm PDTArt J - checkmat.valencia@gmail.com added by Art Jamgochian - checkmat.valencia@gmail.com as a CC'd Recipient Ip: 172.117.173.223
March 29, 2021 1:44 pm PDTArt J - checkmat.valencia@gmail.com added by Art Jamgochian - checkmat.valencia@gmail.com as a CC'd Recipient Ip: 172.117.173.223
March 29, 2021 1:46 pm PDTArt J - checkmat.valencia@gmail.com added by Art Jamgochian - checkmat.valencia@gmail.com as a CC'd Recipient Ip: 172.117.173.223
March 30, 2021 3:52 pm PDTArt J - checkmat.valencia@gmail.com added by Art Jamgochian - checkmat.valencia@gmail.com as a CC'd Recipient Ip: 172.117.173.223
March 31, 2021 10:33 am PDTArt J - checkmat.valencia@gmail.com added by Art Jamgochian - checkmat.valencia@gmail.com as a CC'd Recipient Ip: 172.117.173.223
April 1, 2021 1:43 pm PDTArt J - checkmat.valencia@gmail.com added by Art Jamgochian - art@checkmatvalencia.com as a CC'd Recipient Ip: 172.117.173.223