Release and Waiver of Liability and Indemnity Agreement

(Read Carefully Before Signing)

In consideration of being permitted to participate in any way in the combat sport training indicated below, the participant and/or legal guardian (s) of the minor participant named below agree:

1. You checked with your physician before becoming more active and particularly if any of the following statements apply to you:

- You have been diagnosed with high blood pressure, heart disease, high cholesterol, or any other risk factor for heart disease, stroke, or other injury.

- Your doctor is currently prescribing you drugs for a chronic condition.

- You have a chronic or serious illness.

- You are pregnant.

- You have a family history of high blood pressure, high cholesterol, heart disease, or stroke.

- Your doctor has restricted your physical activity.

- You have been hospitalized in the last three years.

- You feel pain in your chest, dizziness, or shortness of breath when you undertake physical activity.

- You have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your level of physical

activity.

- You have led a sedentary lifestyle.

I understand that it is my responsibility to consult with my physician regarding my ability to participate in a Kadukus Kickboxing exercise program or in any other Kadukus Kickboxing program. Only I (in consultation with my physician) can decide what exercise is medically appropriate for me. I understand that Kadukus Kickboxing instructors and personal trainers are trained in the areas of fitness and health promotion. They are neither trained nor qualified to diagnose, treat, or prescribe treatment for injuries or medical conditions.

2. I agree to obey the policies and rules set at Kadukus Kickboxing in my use of the facilities or such other locations and during my participation in any programs offered. The policies and rules I will follow are:

Do not throw or negligently damage property, equipment, and other human beings

No shoes inside

Clean equipment after use

No food or drinks on the mat

Practice good hygiene BEFORE and AFTER sessions (keep nails trimmed)

Wear clean clothes prior to training

Keep personal equipment clean

All injuries MUST be reported to the trainer

Call 9-1-1 for emergencies

No hard-sparring without supervision

16 oz gloves are required for all live drilling and sparring

Mouthguards are highly recommended for live drilling

Mouthguards are REQUIRED for sparring

All kickboxers and Muay Thai fighters must wear shin guards for live drilling and sparring

Always protect your partner when drilling

No shoes allowed except for clean boxing and wrestling shoes

3. Prior to participating in the below combat sport activities or events, he or she should inspect the facilities and equipment to be used, and if he or she believes anything is unsafe, the participant should immediately advise the officials of such conditions and refuse to participate. I understand and agree that, if at any time, I feel anything to be UNSAFE; I will immediately take all precautions to avoid the unsafe area and REFUSE TO PARTICIPATE further.

4. I/We fully understand and acknowledge the following:

There are risks and dangers associated with participation in combat sport activities or events which could result in bodily injury, partial and/or total disability, paralysis and death.

The social and economic losses and/or damages, which could result from these risks and dangers described above, could be severe.

These risks and dangers may be caused by the action, inaction or negligence of the participant or the action, inaction or negligence of others, including, but not limited to, the Releases named below.

There may be other risks not known to us or are not reasonably foreseeable at this time.

There are also risks and dangers of exposure to Coronavirus, flu of various strains, (Most recently COVID19) and other illnesses known and unknown at this time.

5. I/WE accept and assume such risks and responsibility for the losses and/or damages following such exposure to Coronavirus strains and other illnesses, injury, disability, paralysis or death, however caused and whether caused in whole or in part by the negligence of the Releases named below.

6. I/We HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE the instructor, Juan Perez Babauta III, other participants, including it owners, managers, promoters, lessees of premises used to conduct the training event or program [639 Rocking Horse Court, San Jose, California 95123], premises and event inspectors, underwriters, consultants and others who give recommendations, directions or instructions to engage in risk evaluation or loss control activities regarding the martial arts facility or events held at such facility and each of them, their directors, officers, agents, employees, all for the purpose herein referred to as "Release" from all liability to the undersigned, my/our personal representatives, assigns, executors, heirs and next to kin For any and all claims, demands, losses or damages and any claims or demands therefore on account of any injury, including but not limited to the death of the participant or damage to property, arising out of or relating to the event(s) caused alleged to be caused in whole or in part by the negligence of the releasee or otherwise.

7. I/We HEREBY acknowledge that THE AGLIVILLES OF THE EVENT(S) ARE VERY

DANGEROUS and involve the risk of serious injury and/or death and/or property damage. Each of THE UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES.

8. EACH OF THE UNDERSIGNED further expressly agrees that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the Province or State in which the event is conducted and that if any portion is held invalid, it is agreed that the balance shal, notwithstanding continue in full legal force and effect.

9. On behalf of the participant and individually, the undersigned participants(s) and/or legal guardian (s) for the minor participant executes this Waiver and Release. If, despite the release, the participant makes a claim against any of the Releases, the parent(s) and/or legal guardian(s) will reimburse the Release for any money which they have paid to the participant, or on his behalf, and hold them harmless.

I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY I, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

Juan P. Babauta III

Today’s Date: ___________

Your Name: ___________________ Signature: _________________

Your Phone #: ___________________

Your Email (optional): ___________________

Medical Issues (empty if no): _________________________________

Emergency Contact Name________________ Emergency Phone #:_______________

___ I give consent to having pictures or videos taken for promotional intent.

For Members Under 18

Print name of Parent/Legal Guardian: __________________ Signature:_____________