Student Waiver Form

 
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AGREEMENT, ASSUMPTION OF RISKS, AND WAIVER OF LIABILITY

We at New England Brazilian Jiu Jitsu Academy, as operated by Triangle, LLC (the "Center"), want our students to enjoy and be safe when participating in our martial arts program and activites associated there with (the "Program"). Part of that is informing you of and confirming you understand that there may be risks involved in participating in the Program.

Therefore, in consideration of being permitted to participate in any way in the Program, the participant, and his or her parent(s) and/or legal guardian(s) if the participant is a minor (collectively referred to herein as "You," "I," "We," or the "Participant") hereby certify/certifies that I/We have read and agreed to each of the following provisions and agree to be bound by the terms herein.

  1. The program may be physically demanding and will require the Participant to engage in strenuous physical exercise and activity, either individually or in participation in class with other students or instructors at the Center.

  2. That there are inherent risks and dangers associated with participation  in the Program and that the martial arts  techniques which I learn at the Center are capable of causing minor or serious physical injury, emotional or psychological injury, death, or property damage whenever used against another person or physical objects, either in the Center or elsewhere.

  3. These risks, as well as other risks in participating in the Program, may not be known or reasonably foreseeable at this time.

  4. The types of injuries described above may result not only from intentional action, but also from inadvertent,  negligent, or reckless action, by the Participant or others, including the malfunction or failure of any of the equipment or facilities at the Center (including, but not limited to, pads, protectors, punching bags, and tumbling mats) and errors or mistakes  in instruction or performance of techniques by instructors or other students at the Center.

  5. Each time I participate in the Program, I agree to inspect the facilities and equipment to be used, and if I believe anything is unsafe, I will immediately advise the instructor or another representative of the Center of such condition and decline to participate. I understand and agree that, if at any time, I feel anything to be unsafe, I will immediately take all precautions to avoid the unsafe area and decline to participate further until such condition is remedied.

  6. In the light of all of the foregoing, I/We knowingly and voluntarily agree to assume all of the risks associated with participation in the Program, including those risks described above, and knowingly and voluntarily waive, discharge, agree to hold harmless, and waive any and all rights to initiate or maintain a lawsuit or otherwise seek or obtain any finding of liability against, the Center and any of their owners, operators, officers, employees, instructors, students, or agents arising out of or relating to participation in the Program.

  7. I/We understand that neither the Center nor any of its owners, operators, officers, employees, instructors, students, or agents authorize me to use any of the techniques that I learn in the Program against any other person, in any circumstances other than in the Program.

  8. I/We further expressly agree that the foregoing release is intended to be as broad and inclusive as is permitted by the laws of the State of New Hampshire and that if any portion is held invalid, it is agreed that the balance shall continue in full legal force and effect.

  9. I intend this Agreement, Assumption of Risks, and Waiver to be binding upon any and all of my heirs, assigns, and personal representatives.

Buyer's Rights

I.  Every seller of a martial arts instruction term or monthly contract shall:

(a)  Refund to the buyer the pro rata cost of any unused services, within 15 days after request therefor, if:

(1)  The buyer is unable to receive benefits from the seller's services by reason of death, disability,  or extended illness  beyond 3 months. The martial arts school may require that the disability or extended illness be confirmed by an examination of a physician agreeable to the member and the martial arts school, provided, however, that this subparagraph shall not  operate to prevent the buyer from proving the disability in a judicial proceeding.

(2)  The seller relocates the facility more than 8 miles from its present location, or the services provided by the seller are materially impaired.

(3)  The buyer moves more than 25 miles away from the martial arts school.

(b)  Refund to the buyer the pro rata cost of any unused services within 15 days after the martial arts school ceases operation.

II.  Upon the occurrence of any of the circumstances enumerated in subparagraphs I(a) or (b) of this section, the buyer or the buyer's estate shall be relieved of any further obligation for payment under the contract not then due and owing.

(a)  ""NOTICE TO BUYER: DO NOT SIGN THIS CONTRACT UNTIL YOU HAVE READ ALL OF IT. ALSO, DO NOT SIGN THIS CONTRACT IF IT CONTAINS ANY BLANK SPACES.''

(b)  ""STATE LAW REQUIRES THAT THIS MARTIAL ARTS SCHOOL REGISTER WITH THE BUREAU OF CONSUMER PROTECTION AND ANTITRUST OF THE DEPARTMENT OF JUSTICE AND MAY REQUIRE THAT THIS MARTIAL ARTS SCHOOL POST A BOND TO PROTECT CUSTOMERS  WHO PAY IN ADVANCE FOR MEMBERSHIP OR SERVICES  IN THE EVENT  THIS MARTIAL  ARTS SCHOOL CLOSES. YOU SHOULD  ASK TO SEE EVIDENCE  THAT THIS MARTIAL  ARTS SCHOOL HAS EITHER POSTED A BOND IN COMPLIANCE WITH THE LAW OR HAS BEEN EXEMPTED FROM THIS REQUIREMENT BY THE ATTORNEY GENERAL BEFORE YOU SIGN THIS CONTRACT. IF THIS MARTIAL  ARTS SCHOOL  HAS NOT POSTED  SUCH A BOND, AND YOU PAY THIS MARTIAL ARTS SCHOOL FOR MORE THAN ONE MONTH'S MEMBERSHIP OR SERVICES IN ADVANCE, THEN YOU ARE PAYING FOR FUTURE SERVICES, AND YOU MAY BE RISKING THE LOSS OF YOUR MONEY IN THE EVENT THAT THE MARTIAL ARTS SCHOOL CEASES  TO CONDUCT BUSINESS.''

""YOU MAY CANCEL THIS TRANSACTION IN WRITING ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.''

I/WE HAVE READ THIS RELEASE AND WAIVER OF LIABILITY AND ASSUMPTION OF RISK, FULLY UNDERSTAND ITS TERMS, AND HAVE SIGNED IT FREELY AND VOLUNTARILY.

Name of Participant *
Name of Participant
Address of Participant *
Address of Participant
Phone Number *
Phone Number
At a minimum, please enter a name and phone number.
Participant Signature
By completing this section, you acknowledge that you have read, understood, and agreed to the above text in full.
Date *
Date
Participant Electronic Signature *
To be filled out by participant
Enter your full name to acknowledge your electronic signature of this document.
Guardian Signature (if applicable)
By completing this section, you acknowledge that you have read, understood, and agreed to the above text in full.
Date
Date
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Guardian Electronic Signature