Bucks County Self Defense Waiver, Release, Hold Harmless and Indemnification Agreement, Authorization to Use Pictures and Video Images for Print and Digital Marketing.
In exchange for participation and or allowance to enter the training area or participate in any program at PS Group Holdings facilities, including but not limited to SODACT, Membrella, Mentobo, QMMA, Bucks County Self Defense, Bucks County BJJ, RNACF, Krav Nation, KMG, Bucks County Krav Maga; the undersigned, on his or her behalf, and on the behalf of the Participant(s) identified below, acknowledges, appreciates, understands, and agrees to the following:
1) I represent that I am (we are) am the Participant(s) named below to execute this agreement.
2) I agree to observe and obey all posted rules and warnings, and further agree to follow all oral instructions or directions given by SODACT, or the employees, representatives or instructors of SODACT.
3) I acknowledge and understand that there are risks associated with participation in SODACT activities and the use of training area and equipment including, but not limited to: contusions, fractures, scrapes, cuts, bumps, paralysis or death.
4) I, for myself and the Participant(s) named, willingly assume the risks associated with participation and accept that there are also risks that may arise due to OTHER PARTICIPANTS in which I also willingly assume.
5) I, for myself, the Participant(s) named, our heirs, assigns, representatives and next of kin agree to hold harmless and Indemnify the independent owner(s) of this PS GROUP HOLDINGS, SODACT facility, their predecessors, parent, subsidiaries and affiliates, officers, and employees for any defense cost or expense arising from any and all claims, injuries, liabilities or damages arising from participation.
6) I additionally agree to indemnify the independent owner of this PS GROUP HOLDINGS, SODACT facility, their predecessors, parent, subsidiaries and affiliates, officers, and employees for any defense cost or expense arising from any claims, injuries, liabilities or damages arising from participation.
7) I agree to pay for all damages to the facilities of SODACT caused by my negligent, reckless, or willful actions.
8) Any legal or equitable claim that may arise from participation in the above shall be resolved under Pennsylvania law.
9) I authorize SODACT to use any and all pictures or video images were taken or filmed of me during any days activity. I understand and accept that said pictures or images may be published, including posting to the internet, and acknowledge that I am not entitled to any form of compensation or damages whatsoever relative to said pictures or images.
10) I avow any Participant(s) named are of physical ability to participate and I and Participant(s) named are legally competent to understand and complete this agreement. I hereby execute this agreement without coercion.
11) To help ensure the safety of our students and to maintain the proper culture of our dojo, students must wear SODACT approved attire and MUST train with approved SODACT training equipment.
12) I acknowledge the existence of certain inherent risks in the type of training and hereby agree to assume all risks. I further relieve the studio, it's management, assigned staff, and fellow students from any liability resulting from personal injury or loss of personal belongings. I also hereby state that the students named above are physically fit to take the prescribed course of instruction and do so of their own free will for an agreed-upon fee. I understand there is no refund policy on any monies I will pay SODACT.
13) As Parent and/or Guardian of the named participant, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.
14) I understand there are inherent risks associated with the above training/activity and I assume full responsibility for personal injury, loss or damage because of me, SODACT and its representatives, or other parties.
15) I agree to indemnify and defend SODACT and its representatives, or other parties against any claims, causes of actions, damages, judgements, costs, or expenses including attorney fees and other litigation costs, which may in any way arise from me or my family’s use or presence upon the above facilities, or other parties.4. I agree to pay all damages to the above facilities caused by my negligent, reckless, or willful actions.
16) I affirm I am legally able to handle, utilize and/or possess the applicable firearm(s), ammunition and any other equipment or accessories associated with this course that may be controlled by local, state, or federal statute or regulation.
17) Any legal or equitable claim that may arise from participation in the above will be resolved in accordance with Pennsylvania law.
18) I acknowledge I am under no obligation to sign this agreement and am free to have my own legal counsel review this agreement. I acknowledge SODACT has offered to refund all costs paid minus the original deposit if I choose not to sign this agreement.
19) The invalidity or enforceability of any provision of this agreement, whether standing alone or as applied to a specific occurrence or circumstance shall not affect the validity or enforceability of any provision of this agreement or any provisions of this agreement.
20) Any controversy or claim arising out of or relating to this waiver or breach thereof, shall be settled by arbitration administered by the American Arbitration Association in accordance with its Commercial Arbitration Rules, and judgment on the award rendered by the arbitrator(s) may be entered in any court having jurisdiction.
Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.
Permission is also granted to SODACT and its affiliates including Directors, Coaches, and Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.
In addition, I hold harmless, all instructors, mentors, coordinators, support staff, anyone supporting the programs at any PS Group Holdings operation, including SODACT, Membrella, Mentobo, QMMA, RNACF, Krav Nation, Bucks County Krav Maga from liability if I am injured during training while participating in a program, or at any of the facilities at my own accord.
I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS. BY ACKNOWLEDGING AND CLICKING SUBMIT FORM, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.