Release and Waiver of Liability and Assumption of Risk Form
Please review the terms and conditions and sign below
I hereby consent to members of my family participating in Total Impact Programs or affiliate programs. I recognize that there is an assumption of risk when participating in sports, and understand that injuries including permanent paralysis or death can occur when participating in activities involving motion including but not limited to martial arts and gymnastics. That said, I agree to make myself and my children/family aware of the possibility of injury and encourage my family to follow all safety rules and the teachers' instructions as posted in the gym and as verbally instructed by staff members. I fully understand that Total Impact staff members or its representatives, whether paid or volunteer, to a healthcare facility or hospital.
I understand that it is the express interest of Total Impact to provide for the safety and protection of my child and, in consideration for allowing my child to use this facility, I hereby release Total Impact, its officers, employees, affiliates, teachers, and coaches from all liability for any and all damages and injuries suffered by myself or any member of my family or persons I bring while under the instruction, supervision, control or property of Total Impact.
I also affirm that I now have and will continue to provide proper hospitalization, health, and accident insurance coverage which I consider adequate for my family's and my own protection. I understand that it is the Parents' responsibility to warn the child about the dangers of martial arts or gymnastics and potential injuries as clearly as possible before participating in programs offered. I also understand that safe, Professional instruction often includes hands-on spotting to myself or family members. I permit Total Impact to use any pictures that may be taken of myself or family members. I permit Total Impact to use any pictures that may be taken of myself, family members, or any person(s) I bring for its advertising/direct marketing/web promotions and understand they WILL NOT use my child's full name in the aforementioned projects. This knowledge of risk and waiver of liability, having been read thoroughly and understood completely, is signed voluntarily as to its content and intent. I understand that there are no cash refunds, and agree to follow any and all policies as stated and followed by the company. I have read and understood the general information in this form.
Coronavirus/COVID-19
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. Total Impact Martial Arts ("TIMA") and TIMA Gymnastics have put in place preventative measures to reduce the spread of COVID-19; however, TIMA cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending TIMA classes could increase your risk and your child(ren)'s risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending TIMA and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at TIMA may result from the actions, omissions, or negligence of myself and others, including, but not limited to, TIMA employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)'s attendance at TIMA or participation in TIMA programming ("Claims"). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless TIMA, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of TIMA, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any TIMA program.