South West Martial Arts
108 W. 4th Street Hobart, OK 73651
Participant Liability Waiver, Assumption of Risk, Medical Authorization, and Media Release
Participant Information:
- {name} - Full name
- {dob} - Date of birth
- {address} - Member address
- {phone} - Phone number
- {email}- Email
- {contact_name} - Emergency contact (if member has any)
- {contact_phone} - Emergency contact phone
- {contact_relation} - Emergency contact relation
ASSUMPTION OF RISK
Participation in Brazilian Jiu Jitsu, grappling, wrestling, self-defense, fitness training, competitions, seminars, and related activies involves inherent risks including serious injury, permanent disability, and death. Participant voluntarily assumes all risks associated with participation.
RELEASE OF LIABILITY
Participant releases Southwest Martial Arts, its owners, instructors, coaches, employees, volunteers, contractors, affiliates, successors, and assigns from claims arising from participation to the fullest extent permitted by Oklahoma law.
MEDICAL AUTHORIZATION
Participant authorizes emergency medical treatment when necessary and accepts responsibility for resulting costs.
ADDITIONAL CONSENTS, MEDICAL INFORMATION AND SIGNATURES
Additional Acknowledgements
- Training involves close physical contact, takedowns, submissions, drilling and sparring.
- Participant acknowledges communicable disease risks inherent in close-contact sports
- Participant agrees to follow academy rules and instructor directions.
- Participant grants permission for photos/videos to be used for promotional purposes.
- Oklahoma law governs this agreement.
- {name} - Full name
- {sign_date} - Date document was signed
- - Name of the member or guardian signing the document
