Legacy Martial Arts Sign-up Form

Hi  {name}, This waiver/ release from liability form states:

Voluntary Participation : I, the undersigned, acknowledge and state that my child/ I has applied to voluntarily participate in the Martial Arts lesson being conducted on a weekly basis by  Legacy Martial Arts London (Breen Legacy Academy Ltd). 

Assumption of Risk :  I am aware and understand that, in general, Martial Arts is a dangerous and hazardous activity.  Though my child/ I currently DO NOT have Martial Arts Insurance, they are/ I am voluntarily and of my own free will participating in the Martial Arts lesson being conducted by  the Breen Legacy Academy   with full knowledge and understanding of the serious danger and hazards involved.  I hereby consent and agree to apply for their/ my Martial Arts licence (and insurance) as soon as possible* and I completely accept alone any and all risks of injury or death, and I verify and confirm this statement by placing my initials here:………….

Release:  In consideration for being permitted by  the Legacy Martial Arts London (Breen Legacy Academy Ltd) to participate in the Martial Arts lesson and in consideration for being permitted to use the facilities used by  Legacy Martial Arts London (Breen Legacy Academy Ltd)   in connection with the Martial Arts lesson, I hereby agree that I, my heirs, distributees, guardians, successors in interest and legal representatives will not make a claim or file an action or suit against, sue or attach the property of (a) Steve Payne, Paul Clark, Breen Legacy Academy, Legacy Martial Arts London and/ or any of their respective affiliated organisations, and/ or the shareholders, directors, officers, employees, agents or members (collectively referred to as the complete sponsors),  and (b) any and all manufacturers, distributors, wholesalers, suppliers, retailers, and/ or providers of the facilities and equipment I will use in connection with the Martial Arts lesson and its activities (collectively referred to as the suppliers), (the complete sponsors and the suppliers shall collectively be referred to as Releasees) for damages, injury, emotional distress claims, bodily injury claims and punitive damages, whether known or unknown, foreseen or not, due to or resulting from acts, conduct, negligence, or misfeasance or, or failures to act by, the releasees, or any of them

Health Advisory and Condition:  I hereby acknowledge and understand that participation in the Martial Arts lesson involves extremely strenuous physical activity and that I have been advised to consult a Doctor before commencing and undertaking such activity.  I hereby represent that, to the best of my knowledge, my child/ I am in good physical health and condition, sufficient to undertake the activities and practises required during the lesson.

Knowing and Voluntary Execution:  I hereby declare that I have carefully read this Release of Liability, and that I fully understand the meaning and importance of its contents.  I acknowledge that this Release is a binding contract between  Legacy Martial Arts London (Breen Legacy Academy Ltd)   and me, and that under this contract I am releasing Steve Payne, Paul Clark and Legacy Martial Arts London, Breen Legacy Academy Ltd and/ or any of their respective affiliated organisations from all liability for claims I may have against them.  I further declare and represent that I am at least 18 years of age, that I have full legal capacity to be bound by this contract, and that I am signing this contract of my own free will and accord.

Cancellation Policy:  Cancellation of all monthly memberships require written notice prior to the next payment date.  If the cancellation request is received on or after the scheduled payment date, then there would be no refund for that month.  Any refunds will be at the management discretion but only in exceptional circumstances.

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