WAIVER AND PARTICIPANT AGREEMENT
ADVISORY OF RIGHTS AND RESPONSIBILITIES
Safety is not the sole responsibility of instructors and staff. Everyone in class is responsible for their own safety and the safety of those around them. Students have the right and responsibility to excuse themselves from any exercise they believe will be harmful to them. All students must evaluate each situation in the context of their skill and current physical condition, and conduct each drill in a manner that is safe.If an instructor gives an instruction that is unsafe for the student, it is the student’s responsibility to inform the instructor that the skill may be unsafe. The instructor will routinely excuse the students from unsafe exercises and drills.
Students have a responsibility to train and conduct themselves in a manner that helps all students and instructors remain safe. Students must give those who are training enough room to avoid interfering and avoid being accidentally struck by someone else practicing.
In the event of an injury, students have the right and responsibility to evaluate the extent of the harm, stopping what they are doing even if it includes a partner, and determining if it is safe to continue. Unless a student is certain that further practice will not create or worsen a problem, all students are encouraged to stop what they are doing and inform an instructor. In the event of a serious injury or appearance of a serious injury, all students, instructors, staff and visitors, notably parents, have the right to stop a particular training exercise.
If a student notes an unsafe training situation, which may include a student performing a skill incorrectly, a student not being careful about others, a defect in a piece of training equipment, a potentially dangerous obstacle or condition on the floor, or anything else that may cause or lead to harm of students, instructors, staff, visitors or guests, then the student should correct the situation (such as picking up the piece of equipment left on the floor). If the situation may require the authority of the instructor or staff, or if it is not a simple matter, then an instructor or staff Participant should be notified immediately.
AGREEMENT TO PARTICIPATE
The Participant understands and acknowledges that the inherent nature of the Activity involves close physical contact and strenuous physical exercises, including, but not limited to, punching, kicking, jumping, and sparring exercises, muscle strength and endurance training, cardiovascular conditioning and training, and other various fitness activities and a physical is recommended before starting class. The Participant accepts the complete responsibility for the health and well-being in the voluntary exercise, Muay Thai and MMA programs. The Participant also understands that 1Up MuayThai Academy[*] or the owners of 1Up MuayThai Academy assume no responsibility.
The Participant hereby represents and warrants that he or she is in good physical and mental health and does not suffer from any known disability or condition which would prevent or limit his or her participation in the Activity. Participant hereby recognizes that the Participant’s participation in the Activity carries with it certain risks, including, but not limited to, physical injury, emotional injury, loss to property, economic loss, temporary physical disability, permanent physical disability, and death. The Participant understands and acknowledges that the aforementioned risks may be due to not only the Participant’s own physical condition, actions, inactions, or negligence, but also the following:
a. The actions, inactions, or negligence of other participants participating in the Activity;
b. Latent or apparent defects or conditions of equipment or property supplied by the Participant or other Participants
c. Use of property or equipment supplied by the Participant or other Participants
d. Condition of the facility, terrain, structures, or surrounding grounds connected with the Participant’s participation in the Activity; and
e. Emergency first aid or medical treatment or services rendered in connection with the Participant’s participation in the Activity.
The Participant understands and acknowledges that there are other risks associated with the Activity that are not listed hereinabove. Additionally, the Participant expressly agrees and covenants to accept and assume all other risks arising out of or relating to the Participant’s participation in the Activity. The Participant further assumes and accepts the risk that any medical or physical condition that the Participant may have could be triggered or aggravated by his or her participation in the Activity. Accordingly, the Participant hereby elects to participate in the Activity with full knowledge of and assumption of the risks associated with the Activity.
Participant authorizes 1Up MuayThai Academyl[*] to secure the services of a Physician of Hospital in the event of injury or sickness if a parent or legal guardian is not available. Participant (if minor, parent or legal guardian) agrees to provide payment for any and all expenses for such necessary services. If Participant is a minor, their parents or guardian signature on the injury release form also binds them to this agreement.
ATTORNEY’S FEES
In the event that the Released Parties, or anyone acting on their behalf, incur attorneys’ fees and costs to enforce this agreement or defend against any action brought by the Participant or anyone acting on the Participant’s behalf, the Participant hereby agrees to indemnify the Released Parties and hold them harmless from all such fees and costs.
CHOICE OF LAW AND VENUE
The Participant hereby acknowledges and agrees that this agreement and the rights of the Participant shall be governed by and construed in accordance with the laws of the State of Virginia, including all matters of construction, validity, performance, and enforcement and without giving effect to the principles of conflict of laws. Further, the Participant acknowledges and agrees that, in the event that an action is brought to enforce this agreement, the venue of such action shall lie exclusively within the City of Alexandria, State of Virginia
NOTICE AND CONSENT TO INSTRUCTORS
This school seeks to make sure of highly trained, professional instructors, with expertise and experience both in the art we teach and in teaching. The main instructors may teach classes and should an instructor be unavailable for a given class, an assistant instructor, senior student, or guest instructor may teach. The choice of the instructor is left to the discretion of the school. I understand that I may not always have the instructor that I desire, but I shall seek to learn from whomever is teaching, to show respect to whomever is teaching, and to conduct myself in accordance with the etiquette established at this school. I understand that I take responsibility for my own safety regardless of who is teaching the class. The Participant understands that during the course of instruction, school instructors, authorized personnel and/or other participants will be engaged in a course of conduct requiring physical contact with the Participant. The Participant gives full consent to such contact as is required by the training program and classes. I agree that the full force of this document applies no matter who is teaching.
GUARDIAN
The person(s) signing this agreement as a Guardian agrees to be jointly, severally and individually liable as if signing as the participant.
PERSONAL RESPONSIBILITY
As a Participant (or parent(s) of a Participant), I understand and accept that the use and application of martial arts skills and techniques is the personal responsibility of the student.
As parents, I/we understand and accept that the entrustment of martial arts skills to our children is our responsibility and we will withdraw our students from the program if, in our judgment, we believe your child is a danger to others and should not be entrusted with further martial arts instruction. Should any litigation arise from application of skills learned in this program, whether for proper or improper purposes, successfully or not, the student (and parents, if applicable) agrees to hold harmless and indemnify the school, instructors and agents.
If the Participant is a minor, his/her parents or guardian release 1Up MuayThai Academy[*] and waive all claims for any injuries or negligence of any kind arising out of any trips provided here. I am permitting him/her to make all trips included in the program. Transportation may be provided at the discretion of 1Up MuayThai Academy[*] and falls under the assumption of risk as any other training program at the school.
1Up MuayThai Academy[*] shall be entitled to terminate a Participantship after giving Participant written notice upon occurrence of the following: (A) Any violation of the Participantship agreement (B) Improper conduct by Participant while on school premises (C) Abuse of school facilities (D) Theft of any property belonging to the school, Participants or guests.
Terminated Participants will remain liable for all fees through the month of termination and shall not be entitled any refund. No person whose Participantship has been terminated by the school will be accepted as a guest.
In the event of suit or action to enforce this agreement, Participant agrees to pay such additional sums as collection costs and attorney fees as the trial or appellate court may judge reasonable.
1Up MuayThai school[*] is not responsible for any belongings that get lost or stolen while on the premises.
LATENESS POLICY
• If you are late for a session the session will not be extended and will end at the appointed time.
• If your coach is late for a session, additional time will be added to the session or to subsequent sessions.
CANCELLATION, DEFAULT OR BREACH OF CONTRACT
1. CANCELATION POLICY
• 24 hours notice of cancellation is required for ALL appointments (including but not limited to, private lessons, personal training, physical therapy, dry needling). Notice of less than 24 hours will incur full payment of the session fee.
• If your Coach Cancels a session, additional time (1 week) will be added to the block booking expiration date.
2. LATE FEE
Participant will be charged a $25 late fee if 1Up MuayThai Academy does not receive payment on-time (prior to or every 30 days during the membership contract for those paying on a monthly schedule).
3. NON-CANCELLABLE
Participant cannot cancel this agreement and payments must be made as agreed.
4. NON-USE
The failure or inability of the Participant to use the facilities, classes of services of the school for any reason, will neither relieve nor suspend the Participant’s obligation to make all the payments required under this agreement on a timely basis, nor entitle the Participant to a refund or credit of tuition.
5. DISABILITY
The Participant may extend the term of the agreement at no additional cost for a period of time equal to the duration of a disability where the Participant has a disability precludes the Participant from using one-third or more of the facilities for a period of less than 6 months and the disability is verified by a Physician permanently disabled. A permanent disability means a condition which precludes the Participant from using one-third or more of the facilities for 6 months or more and the condition are verified by a Physician.
6. RELOCATION
The Member may cancel this agreement for a fee of $109, once verified by 1Up MuayThai school[*] (Proof of Address (Credit card Statement, Electrical Bill,etc)), if the Member permanently moves more than 25 additional miles from the school.
7. DEFAULT
Default of this agreement shall constitute non-payment of scheduled monthly payments in excess of 90 days. If this agreement goes into default, the entire contract balance may be payable upon request.
8. ADDITIONAL FEES
In the event this agreement goes into default of Guardian/Member breaches the terms of this agreement, 1Up MuayThai Academy[*] is entitled to legal fees, court fees, interest and penalties. At its discretion, 1Up MuayThai Academy[*] may charge an additional 20% of the outstanding debt and/or 18% annual percentage rate and penalties to cover additional legal costs associated with collection of this agreement, and may assign this agreement to a national collection agency.
9. CANCELLATION OF E-PAY AUTHORIZATION = THE AUTHORIZATION shall remain in full force until such time as Guardian / member offers 30 days written notice to 1Up MuayThai Academy[*] to affect cancellation of E-PAY processing. Cancellation of E-PAY Authorization will not release you from another / initial contractual obligation. Payments will be processed on or about the payment due date and on each consecutive month until paid in full or canceled by its Guardian or Participant.
MEDIA AND SOCIAL MEDIA CONSENTS, release and waiver
I hereby give consent to 1Up MuayThai Academy[*] (the “organization”) to photograph, video, or otherwise digitally record and use images and/or sound recordings of myself or my child/children (if applicable) to use in public media including radio, television, internet, social media print or in any of the organization’s or its partner’s publications, productions or posts. I understand that the intended use of such information is solely for the purpose of marketing, advertising, fundraising and/or promotional and public awareness purposes for the organization. I hereby waive any rights or interest in the images or recordings, as contemplated in their release.
I acknowledge that this consent to use images and/or recordings is being made solely for the benefit of the organization and comes without any expectation of monetary compensation or other benefit to me. To the extent that any benefit accrues or might accrue to the organization from the use of images or information, I hereby and forever waive any interest in or claim such benefits.
I hereby release and forever discharge the organization (including without limitation all corporate affiliates and officers, directors, trustees, donors, employees, agents and volunteers) from any and all claims, liability, actions, suits, demands, costs, expenses, or indebtedness arising out of, related to, or in any way connected with the use of images and materials described herein, and I hereby waive all rights and interest in and to such information and materials.
I further acknowledge that there is no guarantee that any or all of the participants’ images or recordings will be used in any released media.
[*] All references to ‘1UP MuayThai Academy’ herein include all affiliated 1Up MuayThai Academy/Kaileen Lee/Kerem Dincer, LLC services, facilities, businesses, as well as their officers, directors, staff, employees, agents, contractors and servants.
I HAVE READ AND UNDERSTAND THE RELEASE OF LIABILITY AND PARTICIPANT AGREEMENT AND REALIZE THAT PARTICIPATING IN MARTIAL ARTS INVOLVES RISK OF INJURY OR EVEN DEATH. I ATTEST ALL OF THE INFORMATION ENTERED IS ACCURATE. I ALSO ACKNOWLEDGE THAT I READ, UNDERSTAND AND AGREE TO ALL THE AFOREMENTIONED CONDITIONS OF THE AGREEMENT. I AGREE TO ABIDE BY THE RULES AND REGULATIONS OF THE SCHOOL. I UNDERSTAND THAT THE SCHOOL HAS THE RIGHT TO AMEND THE RULES AND REGULATIONS AT ITS DISCRETION WITHOUT DIRECT NOTICE TO ME.