Krav Maga Waiver

Please fill out the following form.

I affirm that I am aware that Krav Maga, and Self-Defense training and operations have inherent risks which may result in serious injury. I acknowledges that taking part in this training activity is potentially dangerous, and involves risk of serious personal injury, death, psychological trauma, and/or other personal and financial liability.

The undersigned agrees to assume all risk and waives any and all claims of liability for personal injury, death, psychological trauma, and/or other personal or financial loss. I understand that martial arts and in particular Krav Maga and Jiu-Jitsu involve certain inherent risks which may require transport to a medical facility. I understand that the activities, which are necessary for training and for certification, maybe conducted at a site that is remote, either by time or distance or both, from such a medical facility. I still choose to proceed with such instructional activities in spite of the possible absence of a medical facility in proximity to the training site. Adir Rafael, the facility at which I receive my instruction, nor any of their respective employees, officers, volunteers, agents, contractors, or assigns, (hereinafter referred to as ‘‘Released Parties’’) may not be held liable or responsible in any way for any injury, death, or other damages to me or my family, heirs, estate, or assigns that may occur as a result of my participation in this, or future, Krav Maga or Jiu-Jitsu classes taken in this facility or as a result of the negligence of any party, including the Released Parties, whether passive or active. 

In consideration of being allowed to participate in this and all future classes, I hereby personally assume all risks, whether foreseen or unforeseen, that may befall me while I am a participant in this and all future classes, including but not limited to the academics, travel, or practical activities. I further release, exempt, and hold harmless said course and Released Parties from any claim or lawsuit by me, my family, estate, heirs, or assigns, arising out of my enrollment and participation in this and future classes including both claims arising during the class or after. I also understand that practicing martial arts and participating in sparring exercises are physically strenuous activities and that I will be exerting myself during this and future training sessions, and that if I am injured as a result of a heart attack, panic, hyperventilation, or any other cause, that I expressly assume the risk of said injuries and that I will not hold the Released Parties responsible for the same. I further state that I am of lawful age and legally competent to sign this liability release, or that I have acquired the written consent of my parent or guardian. I understand the terms herein are contractual and not a mere recital, and that I have signed this document of my own free act and with the knowledge that I hereby agree to waive my legal rights. I further agree if any provision of this Agreement is found to unenforceable or invalid, that provision shall be severed from this Agreement. The remainder of this Agreement will then be construed as though the unenforceable provision had never been contained herein.

I, BY THIS INSTRUMENT AGREE TO EXEMPT AND RELEASE MY INSTRUCTOR, ADIR RAFAEL, THE FACILITY THROUGH WHICH I RECEIVE MY INSTRUCTION, AND ALL RELATED ENTITIES AS DEFINED ABOVE, FROM ALL LIABILITY OR RESPONSIBILITY WHATSOEVER FOR PERSONAL INJURY, PROPERTY DAMAGE, WRONGFUL DEATH HOWEVER CAUSED, PSYCHOLOGICAL TRAUMA, AND/OR OTHER PERSONAL OR FINANCIAL LOSS INCLUDING, BUT NOT LIMITED TO, THE NEGLIGENCE OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE. I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS LIABILITY RELEASE AND ASSUMPTION OF RISK AGREEMENT BY READING IT BEFORE I SIGNED IT ON BEHALF OF MYSELF AND MY HEIRS.

MINOR STUDENT PARENT / GUARDIAN CONSENT:

As the parent or legal guardian of the minor named in of this document, I hereby give my full consent and approval for my child to participate in the listed above. I am willing to assume all risks on behalf of my child.  I hereby certify that my child is fully capable of participating in the designated activity and that my child is healthy and has no physical or mental disabilities or conditions that would restrict full participation in these activities.  

In addition to giving my full consent for my child’s participation, I do hereby waive, release and hold harmless Jericho Tactical Academy, LLC, its officers, instructors, oweners, supervisors, and representatives for any injury that may be suffered by my child in the normal course of participation in the designated sport and the activities incidental thereto, whether the result of negligence or any other cause.  

I understand that by providing my Electronic Signature and by clicking on the "l agree" button below, and clicking on the "next" button below, that I am electronically signing this Consent.