Acknowledge and Release Form
I, the undersigned, on behalf of myself, member of my family, my heirs, executors, administrators and assigns, hereby forever release, discharge and hold harmless Carlson Gracie Miami, representatives and agents for any injury, loss or damage to my person or property howsoever caused, arising out of or in connection with my taking part in Martial Arts Classes, Self Defense Seminars and activities and agents. Please note: Participants must supply their own protective equipment.
The undersigned acknowledge that
His/her is desirous of using, as a member on a membership basis, the Martial Arts School herein referred to as “Carlson Gracie Miami”
His/her has received a completely executed copy of this agreement
His/her confirms that there were o verbal presentations other than those specified in this agreement
His/her may be photographed or filmed while attending at the premises of Carlson Gracie Miami and he/she gives the permission to Carlson Gracie Miami and any facilities to use any and all photos, videos streaming for promotional, sales, publicity and advertising purposes for all media including internet
The waiver was read and he/she agrees to abide by it
You are in good physical condition and have no disability, illness, or other conditions that could prevent you from exercising
You have consulted a physician concerning an exercise program.
If student is under age 18, please provide complete information below