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Hold Harmless/ Waiver/Release Agreement

I understand that the training, instruction, and/or lessons which I have registered for and will receive at SVG MMA ACADEMY involves strenuous physical activity and physical contact with the instructors and students of SVG MMA ACADEMY. These activities may be hazardous and may result in personal injury. The person and guardian (if applicable) whose signature appears below states that he or she has no knowledge of any physical condition that would render these activities dangerous and/or hazardous to his or her health, or the health or his or her ward (if applicable). I promise to notify the SVG MMA ACADEMY instructor immediately, in writing and delivered in, person to an instructor of SVG MMA ACADEMY before the next lesson to be received, if any such condition should develop. After review of the written notification, SVG MMA ACADEMY reserves the right to terminate instruction if the review warrants such action. SVG MMA ACADEMY urges all members to obtain a physical examination from his or her physician prior to the attendance of any program, or use of any equipment at SVG MMA ACADEMY. The enrolled member recognizes that they are enrolling in a martial arts program and that SVG MMA ACADEMY will provide a place of instruction for all classes and practice sessions as well as qualified instructors for these classes. We take reasonable care to prevent accidents and minimize injuries. We require that the student obey the rules and regulations of SVG MMA ACADEMY. No member shall practice free sparring or self-defense techniques without a qualified instructor present. In recognition the person and guardian (if applicable) whose signature appears below, with full personal knowledge, voluntarily waive any right or cause of action of any kind, both individually and for their heirs, executors, administrators and successors, arising as a result of taking martial arts lessons at SVG MMA ACADEMY, other activities, and from any competitions that they may participate in as a student of SVG MMA ACADEMY, which any liability may or could be assigned to SVG MMA ACADEMY, its instructors, employees, officers, administrators, and owners.

Name of Student/Member: {name}

If Student/Member Is Under the Age of 18:

Name of Guardian: {name}

Signature of Guardian: 

Relationship to Student/Member: 

Additional Info:

Email: {email}

Phone: {phone}

Emergency Contact Name: {contact_name}

Phone: {contact_phone}

Date: 

Photo Release:

I grant SVG MMA ACADEMY representatives and employees the right to take photographs of me and my property in connection with Martial Arts. I authorize SVG MMA ACADEMY its assigns and transferees to copyright, use, and publish the photographs in print and/or electronically.

Signature:

Questions:

 1. How did you hear about us?

2. What are your training goals?

3. Are you interested in Morning, Day or Evening classes?

 4. Is this for an Adult or Child?