Waiver

Waiver Intro

This is a binding legal agreement. Clarify any questions or concerns before signing.

I, the undersigned, (“I”, “Me” or “Participant”) am aware that there are significant risks involved in all aspects of physical training and any other sport activities designated below. These risks include but are not limited to: falls which can result in serious injury or death, injury or death due to negligence on the part of myself, my training partner, or other people around me, injury or death due to improper use or failure of equipment. I am aware that any of these above-mentioned risks may result in serious injury or death to myself and or my partner(s). I assume full responsibility, on behalf of myself and any minor for which I am responsible (the “Minor”), for the risks that I am exposing myself to and accept full responsibility for any injury or death that may result from participation in any activity, class or open gym session while at Elemental Ninja.

Name *

Gym Visit Date *

Email *

Address *

City *

Province *

Postal Code *

Country *

Has your doctor ever said you have a heart condition? *YesNo

Do you feel pain in your chest when you perform physical activity? *YesNo

In the past month, chest pain when not performing any activity? *YesNo

Do you lose your balance due to dizziness, or lose consciousness? *YesNo

Do you have a bone or joint problem worsened by physical activity? *YesNo

Is your doctor prescribing medication for blood pressure or a heart condition? *YesNo

Do you know of any other reason why you should not engage in physical activity? *YesNo

Physician Advice

If you answered Yes to any of the above questions, consult your physician before engaging in physical activity. Tell your physician which questions you answered Yes to. After a medical evaluation, seek advice from your physician on what type of activity is suitable for your current condition.

Are you signing on behalf of a minor? *YesNo

Names and ages of all minors

Minors Information

Name *

Age *

Release & Indemnification

RELEASE

In consideration of the above mentioned risks and hazards and in consideration of the fact that I am, or Minor is, willingly and voluntarily participating in the activities available at Elemental Ninja, I, the undersigned hereby waives, releases and irrevocably discharges Elemental Ninja, their principals, officers, directors, agents, suppliers, employees, volunteers and any other representatives (collectively, the “Released Parties”) from any and all liability, claims, demands, actions or rights of action, or losses, which are related to, arise out of, or are in any way connected with my participation in this activity, including those allegedly attributed to the negligent acts or omissions of the Released Parties.

This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect.

If I am signing on behalf of a minor child, I also give full permission for any person connected with Elemental Ninja to administer first aid deemed necessary for myself and/or the child, and in case of serious illness or injury, I give permission to call for medical and or surgical care for myself and/or the child and to transport myself and/or the child to a medical facility deemed necessary for the well-being of myself or the child. I represent and warrant that I have the authority to give such permission in respect of the Minor.

I hereby grant Elemental Ninja, its assigns, licensees and legal representatives the irrevocable right to use my name or the Minor’s name/photograph/image/audio recording/video recording/ and likeness (“My Image”) in all forms and manner including but not limited to publication on Internet Web Sites, broadcasts and any other publications as released to or by Elemental Ninja. I understand that Elemental Ninja cannot control unauthorized use of My or Minor’s Image by persons not associated with Elemental Ninja once My or Minor’s Image has been published. I hereby forever waive any right to inspect or approve any publication of My or Minor’s Image by Elemental Ninja. I also agree to receiving notifications, newsletters and other promotional information from Elemental Ninja and its event sponsors, and understand that I can opt out at any time in the future.

INDEMNIFICATION

The Participant recognizes that there is risk involved in the types of activities offered by Elemental Ninja. Therefore, the Participant accepts financial responsibility for any injury that the Participant or the Minor may cause either to him/herself or to any other participant and/or Minor due to his/her negligence. Should the above-mentioned parties, or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless Elemental Ninja, the Released Parties from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional acts or omission while participating in activities offered by Elemental Ninja.

Signature *

RELEASE

INDEMNIFICATION

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