Name *

First Name

Last Name

Date of Birth *

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Parent/Guardian Name

First Name

Last Name

Phone *

(###)

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Program(s) of Interest

Kickboxing

Boxing

Jiu Jitsu

Muay Thai

MMA

Other

Emergency Contact Name

First Name

Last Name

Emergency Contact Phone Number

(###)

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I, undersigned, agree with the following statements: *

I contract on behalf of myself or my child and assigns, that the company and its insurers, employees, officers, directors, and associates, shall not be liable for any damages arising from personal injuries (including death) sustained by me, or my child in, on, or about the premises, or as a result of the use of the equipment or facilities, regardless of whether such injuries result, in whole or in part, from the negligence of the company.

I assume full responsibility for any and all injuries, damages (both economic and non-economic), and losses of any type, which may occur to me or my child, and I hereby fully and forever release and discharge the company, its insurers, employees, officers, directors, and associates, from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated, or unanticipated, resulting from or arising out the use of said equipment and facilities.

I understand I am solely responsible for safety and wellbeing of my child and myself.

I understand and comply with all rules imposed by the company regarding the use of the facilities and equipment. I conduct myself in a controlled and reasonable manner at all times, and to refrain from using any equipment in a manner inconsistent with its intended design and purpose.

I understand and acknowledge that the use of exercise equipment involves risk of serious injury, including permanent disability and death.

I understand that the company is not responsible for property that is lost, stolen, or damaged while in, on, or about the premises.

I understand and acknowledge that participation in classes, personal training, open sparring, and open mat sessions at Legion MMA involves inherent risks of injury. By signing this waiver, I voluntarily accept and assume all such risks. I hereby release and discharge Legion MMA, its instructors, owners, officers, staff, and fellow participants from any and all liability, claims, demands, or causes of action, whether past, present, or future, arising out of or related to any injury, loss, or damage that may occur as a result of my participation.

I RELEASE OF LIABILITY AND VOLUNTARILY EXECUTED THIS DOCUMENT WITH FULL KNOWLEDGE OF ITS CONTENT.

I give permission to Legion MMA to use my contact information, including email address, phone number, and social media handles, to send promotional offers, gym updates, event announcements, and other related communications. I understand that I can opt out of these communications at any time.

I grant Legion MMA the right to take photographs and video recordings of me while participating in activities at the gym. I authorize the use of these images and recordings for promotional and marketing purposes, including but not limited to social media, website, print materials, and other digital platforms. I understand that no compensation will be provided for the use of these materials.

Today's Date *

MM

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