Accident Waiver and Release Form

Crystal Blake FMA Certified Instructor
Filipino Martial Arts aka, Eskrima/Arnis/Kali
Self-Defense 917-553-4202
ACCIDENT WAIVER AND RELEASE FORM
This accident Waiver and Release of Liability Must Be Signed to participate in any event Participant, Please be advised: 
Stickfighting is dangerous.

Only you are responsible for you, so protect yourself at all times.

“No suing no one, for no reason, for nothing; no how, no way.”

Accordingly, the course of instruction offered by Crystal Blake through FMA Self-Defense consist of a fair amount physical exertion, and thus requires physical endurance, mental,
and emotional limits, and carries with it the potential for loss of property, serious injury, and/or possibly death.
I understand that the course of instruction is sometimes conducted outdoors, exposing students to conditions of terrain, weather, as well as flora and fauna, and that there are risks associated with this type of training. These risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of athletes, equipment, vehicular traffic, actions of other people including, but not limited to participants, volunteers, spectators, coaches, event officials, event monitors, and/or producers of the event, and due to lack of hydration. Also, it should be known that these risks are not only inherent to the participants, but also to volunteers as well.
I, hereby assume all risks while participating and/or volunteering in Private and group instruction as well as events I further realize that liability may arise from negligence or carelessness on the part of the persons or entities involved in these events, and release them from liability due to dangerous or defective equipment or property owned, maintained, and/or controlled by said group because of their possible liability.

I, as a participant, deny any medical, physical, psychological conditions that would prohibit activities in the FMA Self Defense curriculum and I certify that I am physically fit, have sufficiently trained for participation in the instruction/event, and have not been advised otherwise by a qualified medical professional.
In consideration of my application and permission to participate in this event, I hereby take action for executors, my administrators, heirs, next of kin, successors, and myself assign as follows:
A) I Waive, Release, and Discharge, from any and all liability for my death, dismemberment, disability, damaged property, theft, and/or actions of any kind, which may hereafter accrue to me from FMATraining Self-Defense and Fitness, their owners, directors, officers, employees, volunteers, representatives and agents, the event holders, event sponsors, event directors, event volunteers, staff, contractors, and clientele;

B) Indemnify and HOLD HARMLESS the entities or persons mentioned in this waiver of any and all liabilities or claims made by other individuals or entities as a result of any of my actions during this event.

 hereby consent to medical treatment, which may be deemed advisable in the event of injury, accident and/or illness during this event. Should such injury require immediate advanced medical care, I understand that I am personally responsible for all costs and liability of such treatment. 

I understand that this class, event or related activities, I may be photographed and I agree to allow my photo, video or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, and/or organizers with no compensation to me.

I affirm that I will never use the training given by Crystal Blake/FMA self defense curriculum to plan, assist, and/or participate in any criminal or terrorist activity, and that the I am compliant with legal status, manipulated by all levels of government which hold jurisdiction over any locations which used for training purposes.

I acknowledge that this Accident Waiver and Release of Liability form will be used by the event holders, sponsors, Center and organizers in which I participate, and that it will govern my actions and responsibilities during and after said events.

This Accident Waiver and Release of Liability form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

I acknowledge that this Accident Waiver and Release of Liability form will be used by the event holder sponsors, and organizers, in which I participate, and that it will govern my actions and responsibilities during and after said events.
This Accident Waiver and Release of Liability form shall be construed broadly to provide a release and waiver to tile maximum extent permissible under applicable law.

I, certify that I have read the above document, and I understand its content.
By registering, I acknowledge that I have read and understood the entire document.