1LeftAlive Participating Academy/Gym waiver form

1LeftAlive ACKNOWLEDGEMENT OF RISK AND RELEASE OF LIABILITY 18plus

Repeatable form

I, the undersigned, hereby,

ACKNOWLEDGEMENT OF RISK AND RELEASE OF LIABILITY  

For Participants Over the Age of Majority in the Province or Territory in which the
Athletic Activities are Provided by the Organization  

WARNING: THIS AGREEMENT WILL AFFECT YOUR LEGAL RIGHTS.
READ IT CAREFULLY!  

Every Person Read and Understand this Waiver Before Participating in Athletic Activities  

By allowing the use of your academy/gym/facility, I hereby waive all claims, release from all liability, assumption of all risks, and other terms of this agreement as entered into by me (the "Participant", "participating" / "Academy/Gym/Facility") with and for the benefit of: their directors, officers, employees, volunteers, business operators, agents and site property owners or Occupiers (the "Organization", or "Ontario Inc. #2129184 or "Oracle Jiu Jitsu" or "1LeftAlive"). Occupiers is defined in accordance with the definition of Occupiers contained in the Occupiers Liability legislation applicable to the Province or Territory in which the Athletic Activities are provided by the Organization. I freely acknowledge the temporary use of said facility for the express purpose of a temporary set of athletic competitive matches where I will not seek any form of compensation for said useage.

Please check box/item below (in place of initials) after Reading and Understanding each item:  

Athletic Activities" include but are not limited to contact and non-contact sports, fitness activities, personal training instruction and activities, use of facilities, and fitness programs and services provided to the Participant by the Organization.

By check marking the below boxes, you consent as your initials: *

1. I am aware that there are inherent and significant risks ("Risks") associated with the participation in Athletic Activities. I am aware that those Risks include, but are not limited to, the potential for serious personal injury caused by any event or any condition of the facility or equipment where Athletic Activities are provided by the Organization, and health risks such as transient lightheadedness, fainting, abnormal blood pressure, chest discomfort, muscle cramps or soreness, and nausea. I understand the Risks are relative to my own state of fitness and health (physical, mental and emotional), and to the awareness, care and skill with which I conduct myself while participating in Athletic Activities.

2. I freely accept and fully assume all responsibility for all Risks and possibilities of personal injury, death, property damage or loss resulting from my participation in Athletic Activities. I agree that although the Organization has taken steps to reduce the Risks and increase safety of the Athletic Activities, it is not possible for the Organization to make the Athletic Activities completely safe. I accept these Risks and agree to the terms of the waiver, even if the Organization is found to be negligent or in breach of any duty of care or any obligation to me in my participation in Athletic Activities.

3. I acknowledge my obligation to immediately inform the nearest employee of the Organization if I feel any pain, discomfort, fatigue or other symptoms that I may suffer during and immediately after my participation in Athletic Activities. I understand I may stop participation at any time, and I may be requested to stop by an employee or volunteer of the Organization who observes any symptoms of distress or abnormal response.

4. I confirm that I have reached the age of majority in the province or territory in which I am participating in Athletic Activities.

5. In addition to consideration given to the Organization for my participation in Athletic Activities, I and my heirs, next of kin, executors, administrators and assigns (collectively my "Legal Representatives') agree: a. To waive all claims that I have or may have in the future against the Organization; to release and forever discharge the Organization from all liability for all personal injury, death, property damage, or loss resulting from my participation in the Fitness Activities due to any cause, including but not limited to negligence (failure to use such care as a reasonably prudent and careful person would use under similar circumstances), breach of any duty imposed by law, breach of contract or mistake or error of judgment of the Organization; and b. To be liable for and to hold harmless and indemnify the Organization from all actions, proceedings, claims, damages, costs demands including court costs and costs on a solicitor and own client basis, and liabilities of whatsoever nature or kind arising out of or in any way connected with my participation in Athletic Activities. c. I agree that this waiver and all terms contained within are governed exclusively by the laws of the Province or Territory of Canada in which the Athletics Activities are provided to me by the Organization. hereby irrevocably submit to the exclusive jurisdiction of the courts of that Province or Territory. Any litigation to enforce this waiver must be instituted in the Province or Territory in which the Athletic Activities are provided by the Organization.

6. I confirm the use of my image captured in class videos for the purposes of security, abuse prevention and/or as part of online for profit video curriculum. I make no claim now or in the future for the use of my image in said videos. Videos may include for the purposes of promotion and advertising.6. I confirm the use of my image captured in class videos for the purposes of security, abuse prevention and/or as part of online for profit video curriculum. I make no claim now or in the future for the use of my image in said videos. Videos may include for the purposes of promotion and advertising.

7. I confirm that I have had sufficient time to read and understand each term in this waiver in its entirety, and have agreed to the terms freely and voluntarily. I understand that this waiver is binding on me and my Legal Representatives.

8. I confirm that I am the owner and/or have signing authority over the signed academy/gym/facility8. I confirm that I am the owner and/or have signing authority over the signed academy/gym/facility

9. I hold #2129184 Ontario Ltd, Oracle Jiu Jitsu and/or 1LeftAlive free of all claims and release from all liabilities.9. I hold #2129184 Ontario Ltd, Oracle Jiu Jitsu and/or 1LeftAlive free of all claims and release from all liabilities.

Academy/Gym/Facility's legal name

Academy Owner's Name: (first and last) *

Academy Street address: *

Academy City: *

Academy Country: *

Academy Postal/Zip code: *

Email: (required if you would like a copy sent to you) *

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Participating Academy Witness Signature: *

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Organization Witness Name:

Organization Witness Signature

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