Cornerstone Mixed Martial Arts
Wavier and Release of All Claims
(Must be signed or registration cannot be processed)
Please read this form carefully and be aware that by registering yourself (or your minor child) for
participation in Cornerstone Mixed Martial Arts, LLC programs, you are waiving and releasing any and all claims for injuries you (or your child) might sustain arising out of said activities, classes or programs.
“I, , have enrolled (or have enrolled my child) in the martial arts, health and fitness program(s) offered through Cornerstone Mixed Martial Arts, LLC.
I recognize that these programs and classes may involve various forms of physical activity including, but not limited to, endurance training, muscular conditioning, certain training drills, and other strenuous fitness activities. I hereby affirm that I am in good physical condition and do not suffer from any known disability or condition which would prevent or limit my participation in this exercise program. I acknowledge that my enrollment and subsequent participation is purely voluntary and in no way mandated by Cornerstone Mixed Martial Arts, LLC. I also recognize and fully understand that in the martial arts, health and fitness program(s) that I have enrolled in, there is a high degree of risk of physical injury to the participants in these activities, classes or programs.
I fully understand that I may injure myself as a result of my enrollment and subsequent participation in these activities, classes or programs. I agree to assume the full risk of any such injuries, damages or loss, regardless of severity or fault, which I (or my child) may sustain as a result of participating in any activities, classes or programs offered through Cornerstone Mixed Martial Arts, LLC.
In consideration of my participation in these program(s), I hereby fully release and discharge Cornerstone Mixed Martial Arts, LLC. and its members, managers, directors, officers, agents, servants and employees from any and all claims from injuries, damage or loss which I (or my child) may have sustained or which may accrue to me (or my child) on account of my voluntary participation (or the voluntary participation of my child) in any of these activities, classes or programs.
I, further agree to indemnify, hold harmless and defend Cornerstone Mixed Martial Arts, LLC its
members, managers, directors, officers, agents, servants and employees from any and all claims resulting from injuries, damages and losses sustained by me (or by my child,) and arising out, connected with, or in any way associated with my voluntary participation in any of the activities, classes or programs for which I (or my child) is enrolled.
I, agree to observe and obey all posted rules and warnings, and further agree to follow any and all oral instructions and directions given by, Cornerstone Management, the instructors, the employees, authorized representatives or agents of Cornerstone Mixed Martial Arts, LLC.
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Cornerstone Mixed Martial Arts
Wavier and Release of All Claims
(Must be signed or registration cannot be processed)
Photo Disclaimer: Registrants and participants who register for programs and special events, agree and permit Cornerstone Mixed Martial Arts, LLC to take photographs and videos of themselves and their child for publication in the program brochure, website and any additional commercial uses for
Cornerstone Mixed Martial Arts, LLC. Registrant or participant may opt out of all photographs and
videos by expressively filing a written objection to the management that no photographs or videos of
themselves and/or their child are to be being taken.
I state and affirm, that I am over the age of eighteen (18) years old for purposes of executing this
document and have had an opportunity to ask questions of the management of Cornerstone Mixed Martial Arts as to the martial arts, health and fitness classes I am enrolling in.
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I HEREBY AFFIRM THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE
STATEMENTS.
Date: {sign_date}
Printed Name of Participant
Parent Authorization
By signing and printing my name below, I hereby authorize {name} to participate in Cornerstone Mixed Martial Arts, LLC program(s) (if participant is under the age of 18 years old).
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Cornerstone Mixed Martial Arts
