Fillable Student Registration And Liability/waiver Form (Page 2 of 2) in pdf

SOARING EAGLE KUNG FU, INC.

Assumption of Risk, Waiver, and Release from Liability

I, __________________________________________, desire to participate in classes provided by SOARING EAGLE KUNG FU, INC. (hereinafter "SOARING

EAGLE”). This Assumption of Risk, Waiver, and Release from Liability covers the entirety of my participation in the SOARING EAGLE , including travel to any

locations off of the SOARING EAGLE Studio in order to participate in activities associated with the SOARING EAGLE .

Risk Factors- I understand and acknowledge that participation in the SOARING EAGLE involves risks including, but not limited to the following: risk of

property damage, bodily injury, including, but not limited to permanent disability, paralysis, and possibly death. These risks may result from a variety of

circumstances including, but not limited to, my own and others actions, inactions or negligence, the rules of the martial arts, or conditions of the facilities and

equipment provided by SOARING EAGLE or from the unavailability of emergency medical care.

Assumption of Risk- I am participating in the SOARING EAGLE at my own free will. I understand that my decision to participate in the SOARING EAGLE is

entirely voluntary. I assume full responsibility for all risks that may arise out of or result from my participation in the SOARING EAGLE, including by not

limited to those risks described in Section 1, above. Excepted from this section are any injuries caused by the gross negligence or willful or wanton

misconduct of any officials, officers, employees, agents, or volunteers of SOARING EAGLE Kung Fu School.

Acknowledgement of Policies and Procedures- I acknowledge that I have read, know, and agree to all of the policies and procedures relating to my participation

in the SOARING EAGLE . I understand that the safe and proper use of all facilities, equipment or participation in the activity is dependent upon carefully

following these policies and procedures. I agree to comply with and abide by all rules, regulations and policies of the Ray Meyer Fitness and Recreation Center

and of SOARING EAGLE Kung Fu School. I understand that SOARING EAGLE Kung Fu School reserves the right to revoke or terminate my participation in

the SOARING EAGLE for any violations of these rules, regulations, or policies.

Release, Indemnify, and Defend. I hereby release, waive, discharge, and hold harmless SOARING EAGLE Kung Fu School, and all of their affiliates,

predecessors, successors, trustees, officers, directors, faculty, employees, agents and representatives, past or present (hereinafter jointly referred to as “the

Released Parties") from any and all claims, suits, liabilities, judgments, costs and expenses ("Claims") for any property damage, property loss or theft, personal

injury or illness, death or other loss arising from or relating to my participation in the SOARING EAGLE. I also agree to defend, indemnify and hold harmless the

Released Parties from and against any Claims arising from or related to my own acts or omissions in connection with my participation in the SOARING EAGLE.

Prerequisite Skills. I acknowledge that I have the requisite skills, qualifications, physical ability and training necessary to properly and safely participate in the

Club Sport Program. I agree that if I have any questions as to what skills, qualifications, or training is necessary to properly participate in the SOARING EAGLE,

then I shall direct such questions to the appropriate individuals.

Waiver- I hereby waive any protections afforded by any statute or law in any jurisdiction whose purpose, substance and/or effect is to provide that a general

release shall not extend to claims, material or otherwise which the person giving the release does not know or suspect to exist at the time of executing the release.

This means, in part, that I am releasing unknown future claims.

Payment for Damages. I agree to pay for any and all damages to any property or Release Party caused by me negligently, willfully or otherwise.

Representatives. I enter into this agreement for myself, as well as for my heirs, assigns and legal representatives.

Consent for Emergency Treatment- I consent to medical treatment for emergencies that occur during or are related to my participation in the SOARING

EAGLE where I am unable to consent to such treatment. I understand the provisions of this Assumption of Risk, Waiver, and Release from Liability apply to any

treatment that might be provided to me under this Section, including but not limited to Section 1, Section 2, and Section 4.

10. Insurance- I understand that I am solely responsible for any medical, health or personal injury costs relating to my participation in the SOARING EAGLE . I

understand that I am strongly encouraged to have a medical physical examination and purchase health insurance prior to any and all participation in the

SOARING EAGLE.

11. Jurisdiction. This Assumption of Risk, Waiver, and Release from Liability shall be governed in all respects by the laws of the State of Illinois. The parties agree

to use the State of Illinois for Jurisdiction and the County of Cook County/Lake County as Venue for any disputes between the parties related to this Assumption

of Risk, Waiver, and Release from Liability.

12. Severability. If any term or provision of this Assumption of Risk, Waiver, and Release from Liability is held to be illegal, invalid or unenforceable, or the

application thereof to any person or circumstance shall to any extent be illegal, invalid or unenforceable under present or future laws effective during the term

hereof or of any provisions hereof which survive termination, then and in any such event, it is the express intention of the parties that the remainder of this

Assumption of Risk, Waiver, and Release from Liability, or the application of such term, clause or provision other than to those as to which it is held illegal,

invalid or unenforceable, shall not be affected thereby, and each term, clause or provision of this Assumption of Risk, Waiver, and Release from Liability and the

application thereof shall be legal, valid and enforceable to the fullest extent permitted by law.

I have read and fully understand this Assumption of Risk, Waiver, and Release from Liability and understand that it relates to surrendering and releasing valuable

legal rights. I do so freely and voluntarily.

PRINTED NAME: ____________________________________ SIGNATURE: ______________________________________ Date: _______________

Consent and Release on Behalf of Minor by Parent/Legal Guardian

I am the parent or legal guardian of the above named minor. I have read and understand this Assumption of Risk, Waiver, and Release from Liability in its entirety and

understand that it relates to surrendering valuable legal rights of the minor and myself. I agree to be bound by all the terms of the Assumption of Risk, Waiver, and

Release from Liability. I also give my consent to the participation in the activity of the minor.

PRINTED NAME: ____________________________________ SIGNATURE: ______________________________________ Date: _______________