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Midcoast Fitness and Self Defense

General Release & Waiver of Liability and Indemnity Agreement

(Read Carefully Before Signing or Acknowledging Receipt)

In consideration of being permitted to participate in any way in the Midcoast Fitness and Self Defense (herein referred to as MFSD) Program and any of its classes

and/or being permitted to enter for any purpose any restricted area (here in defined as any area where in admittance to the

general public is prohibited), I or the parent(s) and/or legal guardian(s) of the minor participant named below agree:

1. The participant or the parent(s) and/or legal guardian(s) will instruct the minor participant that prior to participating in the below fitness/self-defense activity or event, he or she should inspect the facilities and equipment to be used, and if he or she believes anything is unsafe, the participant should immediately advise the officials of MFSD of such condition and refuse 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 REFUSE TO PARTICIPATE further.

2. I/We represent that we have NO KNOWLEDGE of ANY MENTAL or PHYSICAL condition, history or pre-existing condition that would render it dangerous or hazardous to participate in any fitness and self-defense activities, classes, seminars or events at MFSD.

3.  I/We understand that we have been advised to obtain the consent of my/our physician prior to beginning any fitness / self-defense activity, as you would with any exercise and/or nutrition program and that if I /we choose not to obtain the consent of my/our physician and/or work with our physician throughout the duration of our training that we agree to accept full responsibility for my/our actions.   

3. I/We accept and FULLY UNDERSTAND that the activities may include physical contact, strenuous physical activity and physical contact by instructors for reasons of safety, learning or adjustment involved in the activity.

4. I/We fully understand and acknowledge that:

a. There are risks and dangers associated with participation in fitness and self-defense events and activities which could result in bodily injury partial and/or total disability, paralysis and death.

b. The social and economic losses and/or damages, which could result from these risks and dangers described above, could be severe.

c. These risks and dangers may be caused by the action, inaction or negligence of the participant or the action, inaction or negligence of others, including, but not limited to, the Releasees named below.

d. There may be other risks not known to us or are not reasonably foreseeable at this time.

5. I/WE accept and assume such risks and responsibility for the losses and/or damages following such injury, disability, paralysis or death, however caused and whether caused in whole or in part by the negligence of the Releasees named below.

6. I/We HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE the MFSD fitness and self-defense facility used by the participant, including it owners, managers, promoters, lessees of premises used to conduct the fitness and self-defense event or program, premises and event inspectors, underwriters, consultants and others who give recommendations, directions or instructions to engage in risk evaluation or loss control activities regarding the MFSD fitness and self-defense facility or events held at such facility and each of them, their directors, officers, agents, employees, all for the purpose herein referred to as "Releasee"…From all liability to the undersigned, my/our personal representatives, assigns, executors, heirs and next to kin For any and all claims, demands, losses or damages and any claims or demands therefore on account of any injury, including but not limited to the death of the participant or damage to property, arising out of or relating to the events(s) caused alleged to be caused in whole or in part by the negligence of the releasee or otherwise.

7. I/We HEREBY acknowledge that THE ACTIVITIES OF THE EVENT(S) ARE VERY DANGEROUS and involve the risk of serious injury and/or death and/or property damage. Each of THE UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES.

8. EACH OF THE UNDERSIGNED further expressly agrees that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the Province or State in which the event is conducted and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding continue in full legal force and effect.

9. On behalf of the participant and individually, the undersigned partners(s) and/or legal guardian(s) for the minor participant executes this Waiver and Release. If, despite the release, the participant makes a claim against any of the Releasees, the parents(s) and/or legal guardian(s) will reimburse the Releasee for any money which they have paid to the participant, or on his behalf , and hold them harmless.

I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WTHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

Student(s) under 18 years of age MUST have waiver signed below, by parent or legal guardian. Student(s) not accompanied by guardian MUST bring signed waiver to first class, or participation will be denied.

Fitness and Self Defense Facility: MFSD - Midcoast Fitness and Self-Defense (Releasee)

Student/Participant Signature and Date _________________________________________________________________________

Parent or Guardian Signature (if minor) __________________________________________________________________

Printed Name of Participant ____________________________________________________________________________

Address, Email and Phone of Participant _________________________________________________________________________________

Received by   _____________________________________________________________________________

Registrar Signature Printed Name Date 

I am acknowledging by signing that I represent that I have no knowledge of any mental or physical condition that would render it dangerous or hazardous to my health or safety to participate in fitness and self-defense classes or seminars held at a Mid-Coast Fitness (MFSD) facility or affiliate facility, this includes any venue or location that the above deems necessary for teaching fitness and self-defense. I am fully aware, understand and acknowledge that this class or classes may at times involve strenuous and/or physical activity that may include physical contact with another participant or instructor.  Instructors may at times make physical contact for reasons of safety and/or adjustment involved in training.  There are risks and dangers associated with participation in self-defense activities which could result in bodily injury, partial and or total disability, paralysis and death and the social and economic losses and/or damages, which could result from these risks and dangers described above, could be severe.  These risks and dangers may be caused by the action, inaction or negligence of the participant or the action, inaction or negligence of others.  There may be other risks not known to us, MFSD, or are not reasonably foreseeable at this time.

I assume all risks of injury, loss of life, damages to person and or property during such activity. I fully hold MFSD, their partners, its instructors and/or agents, employees, successors and students and all participants in fitness or self-defense classes held at any Mid-Coast Fitness and Self Defense facility or affiliate facility harmless from all liabilities, claims, demands, costs, losses, expenses or compensation of any nature, including acts of negligence, for loss, damage, death or injuries to person and property sustained by me, my heirs, personal representatives, successors and assigns. I also assume all risk of injury, loss of life and damage to person and property during such activities resulting from or in any way connected with the use of equipment furnished by MFSD, whether directly or indirectly causing or contributing to injury, loss of life or damage to person or property. I/WE hereby RELEASE, WAIVE, DISCHARGE and COVENANT NOT TO SUE MFSD.

I authorize and give permission to MFSD, the instructors, their partners and/or agents, to exhibit my name, use, copy, reproduce, display, distribute, publish and exhibit any pictures/video/narrative taken during the seminar, without restriction. This authorization includes any means of communication at any place for any lawful purpose. I waive any right I might have to inspect and/or approve the copy that may be used or the use to which it may be applied.

I understand that this document constitutes a full and complete waiver of all possible claims for any act or omission, including claims for negligence regarding injury or property damages, arising from my participation in MFSD classes or seminars.  All conditions on this waiver have been read and fully understood and are accepted and agreed upon by my signature above.