GRACIE HUMAITA SEMO, LLC

Release, Liability WAIVER & Indemnity Agreement

(Read Carefully Before Signing)

In consideration of being permitted to participate in any way in any Martial Arts Program, as defined below, by GRACIE HUMAITA SEMO, LLC dba GRACIE HUMAITA SEMO, GRACIE HUMAITA JACKSON, GRACIE HUMAITA CAPE, GRACIE HUMAITA CAPE GIRARDEAU, GRACIE HUMAITA SOUTHEAST MISSOURI, CAPE BJJ, and CAPE BJJ AND FITNESS (hereinafter GRACIE HUMAITA SEMO), currently located at  3210 Old Cape Rd, Jackson, MO 63755 (the “Premises”), I, or, if a minor, the parent(s) and/or legal guardian of the minor participant named below (hereinafter, collectively, “I,” “me” or “my”), enter into this Release, Liability Waiver and Indemnity Agreement (“Agreement”) and hereby agree:

1. I am voluntarily seeking and consenting to participate in GRACIE HUMAITA SEMO’S Martial Arts Program, which is defined to include, but not be limited to, martial arts instruction and related training, including those in the arts of Brazilian jiu-jitsu, judo, ground fighting, grappling and other martial arts that commonly involve body contact with the ground as well as techniques such as chokes and joint locks; Muay Thai and other martial arts that commonly involve striking; mixed martial arts (MMA); self-defense training; and other martial arts that may be offered in the future and from time to time; physical, strength and/or cardio conditioning; yoga and other flexibility or meditative exercises; and other similar or related physical activities. I understand that the various activities of the Martial Arts Program may take place in, outside of, around and off the Premises, and I have the choice not to participate in any or all activities, events or competitions offered by GRACIE HUMAITA SEMO.

2. I represent and warrant that I am either of proper physical condition to participate in the Martial Arts Program, understanding the demands and nature of the activities provided above, or accept full responsibility for my participation therein in my current physical state. I agree to disclose all medical conditions, ailments and other issues to GRACIE HUMAITA SEMO prior to my participation in the Martial Arts Program and understand that my failure to do so further waives GRACIE HUMAITA SEMO’S liability from any and all injuries or other outcomes related to my continued participation in the Martial Arts Program.

3. I fully understand and acknowledge that THE ACTIVITIES OF THE MARTIAL ARTS PROGRAM ARE INHERENTLY DANGEROUS, such that:

A. There are risks and dangers associated with my participation in the Martial Arts Program that could result in bodily injury, partial and/or total disability, paralysis or death.

B. The social and economic losses and/or injuries that could result from these risks and dangers described above could be severe.

C. These risks and dangers may be caused by the action or inaction of myself or others, including, but not limited to, GRACIE HUMAITA SEMO and/or other participants in the Martial Arts Program; the rules and regulations of the Martial Arts Program; or the nature of the facilities or equipment used.

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

4. I understand, accept and assume the above risks and dangers, both known and unknown, and I assume full responsibility for the injuries, maladies, losses and/or damages resulting therefrom, however caused and whether caused in whole or in part by GRACIE HUMAITA SEMO.

5. I understand and accept that I use any and all equipment and facilities “as-is” and at my own risk and peril, and I hold GRACIE HUMAITA SEMO harmless from any and all consequences resulting therefrom, including, but not limited to, injury, malady, loss and death, regardless of the cause. I further understand that said use is voluntary and by my own choice, and I may refuse said use and/or request the use or application of alternative equipment and facilities, although GRACIE HUMAITA SEMO is not obligated either to provide alternate accommodations or to compensate me for its refusal to do so.

6. From time to time, GRACIE HUMAITA SEMO may host, organize or sponsor social and other extracurricular activities and events in, outside of, around and off of the Premises that may or may not be directly related to the Martial Arts Program. I understand that my involvement and/or participation in them is completely voluntary and agree that the terms of this Agreement shall extend to, and include, such events and activities.

7. In the event that GRACIE HUMAITA SEMO provides transportation to the Premises or any other location where GRACIE HUMAITA SEMO is conducting any activity, event or gathering, I understand that my consent to be transported is completely voluntary and hereby agree that GRACIE HUMAITA SEMO shall not bear any liability for any injury, loss, destruction, death or any other similar or related consequence either to my person or my property during or as a result of such transportation, whether or not foreseeable and regardless of the cause. I further understand that GRACIE HUMAITA SEMO is not obligated to provide any transportation whatsoever on any occasion, and I assume full responsibility for any injury, loss, destruction, death or other similar or related consequence either to my person or my property during or as a result of my choice of transportation.

8.I HEREBY FOREVER RELEASE, WAIVE, FOREVER DISCHARGE, HOLD HARMLESS, AGREE TO INDEMNIFY AND DEFEND, AND COVENANT NOT TO SUE GRACIE HUMAITA SEMO, its members, managers, owners, employees, officers, directors, agents, instructors, volunteers, assistants, administrators, coaches, and their affiliated clubs and organizations’ administrators, directors, agents, coaches, employees, supervisors; and other participants, participants’ parents and/or guardians; and sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of the premises used to conduct any event or training, all of which are hereinafter referred to as “releasees”, from any and all liability, claims, damages, demands, costs, actions, causes of action, or suits of any nature or kind whatsoever which the undersigned, their heirs, parents, guardians, next of kin, executors, administrators, personal representatives, or assigns may have or claim to have, on account of or arising out of the personal injuries, death or damage to their person(s) or property or involving any impairment or damage to any right, including, but not by way of limitation, loss of time, loss of service, loss of income, or for expenses incurred, occurring to them because of or in any way relating to participation by the undersigned in activities of GRACIE HUMAITA SEMO and any of its members, managers, owners, employees, officers, directors, agents, instructors, volunteers, assistants, administrators, coaches; and GRACIE HUMAITA SEMO, and its members, managers, owners, employees, officers, directors, agents, instructors, volunteers, assistants, administrators, and coaches or through the use of any and all facilities connected therewith, or caused or alleged to be caused in whole or in part by any action or non-action undertaken by GRACIE HUMAITA SEMO or fellow releasees; all acts of negligence on the part of GRACIE HUMAITA SEMO or fellow releasees; or acts or omissions of any rescue/emergency actions or medical treatment undertaken by GRACIE HUMAITA SEMO or releasees, if any.  This Agreement and release shall extend to my personal representatives, assigns, executors, heirs and next of kin.

9. I further expressly agree that this Agreement is intended to be as broad and inclusive as permitted by law. Any portion that is uncertain or challenged as to its validity or enforceability shall be interpreted so that it most closely reflects the intent of the parties in entering into this Agreement, to the greatest extent permitted by law. Otherwise, if any portion herein is held invalid or otherwise legally unenforceable by a court of competent jurisdiction, both GRACIE HUMAITA SEMO and I agree that the remainder of this Agreement shall remain in full force and effect.

10. I understand that the skills taught in GRACIE HUMAITA SEMO’S Martial Arts Program are to be used solely in accord with the law, that I have been explicitly instructed to not use the skills taught at GRACIE HUMAITA SEMO outside of class with the exception of sanctioned tournaments or events. I am solely responsible for my actions using the skills taught by GRACIE HUMAITA SEMO, and agree to defend and indemnify GRACIE HUMAITA SEMO for any of my actions that result in claims against GRACIE HUMAITA SEMO.

11. I agree that GRACIE HUMAITA SEMO may use my image, photo, likeness for any purpose, including but not limited to: GRACIE HUMAITA SEMO website, promotions, instructional videos, and school advertisements.

12. Should any legal dispute arise out of this Agreement, or regarding any subject matter contained herein, I agree to pay for all attorney’s fees and costs reasonably incurred by GRACIE HUMAITA SEMO in defense of any such dispute.

13. I agree to hold GRACIE HUMAITA SEMO harmless and reimburse GRACIE HUMAITA SEMO for any and all costs incurred on my behalf.

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

Name of Participant:  

Signature of Participant/Parent or Guardian (if Minor):