WAIVER AND RELEASE OF LIABILITY
READ THIS DOCUMENT CAREFULLY AS THIS AFFECTS YOUR LEGAL RIGHTS
IN CONSIDERATION OF the risk of injury that exists while participating in the activity of Martial Arts and Fitness Instruction (hereafter the "Activity") as organized by Black Belt Acai, LLC d.b.a Gracie Barra Birmingham USA (hereafter Black Belt Acai, LLC) of 4401 4th Ave S, Birmingham, Al. 35222 and/or use of the property, facilities, and services of Black Belt Acai, LLC and,
IN CONSIDERATION OF my desire to participate in said Activity and being given the right to participate in same;
I HEREBY, for myself, my heirs, executors, administrators, assigns, or representative (hereinafter collectively "Releasor", "I", or "me", which terms shall also include Releasor's parents or guardian if Releasor is under 18 years of age), knowingly and voluntarily enter into this Waiver and Release of Liability and hereby waive any and all rights, claims or causes of action of any kind arising out of my participation in the activity, and
I HEREBY release and forever discharge Black Belt Acai, LLC, located at 3800 3rd Avenue S, Birmingham, Alabama. 35222, their affiliates, managers, members, agents, attorneys, staff, heirs, representatives, predecessors, successors, and assigns (collective "Releasees), from any physical or psychological injury that I may suffer as a direct result of my participation if the aforementioned Activity.
I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO: PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS DISFIGUREMENT, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS' NEGLIGENCE, CONDITIONS RELATED TO TRAVEL TO AND FROM THE ACTIVITY, OR FROM CONDITIONS AT THE ACTIVITY LOCATION(S). NONETHELESS, I ASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY.
I FURTHER AGREE to indemnify, defend and hold harmless the Releasees against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney's fees and any related costs.
I FURTHER ACKNOWLEDGE that Releasees are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Releasees. In the event that I should require medical care or treatment, I authorize Black Belt Acai, LLC to provide all emergency medical care deemed necessary, including but not limited to, first aid, CPR, the use of AEDs, emergency medical transport, and sharing of medical information with medical personnel. I further agree to assume all costs involved and agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance.
I FURTHER ACKNOWLEDGE that this Activity may involve a test of a person's physical and mental limits and may carry with it the potential for death, serious injury, and property loss. I agree not to participate in the Activity unless I am medically able and properly trained, and I agree to abide by the decisions of the Black Betl Acai, LLC official or agent, regarding my approval to participate in the activity.
I FURTHER ACKNOWLEDGE that my mailing address, telephone number, cell phone number, and email address provided to the Releasees are accurate and were provided by me voluntarily. Subject to applicable law, I agree that Releasees may contact me at any mailing address, telephone number, cell phone number, or email address I provide for any legal reason and within the scope of normal business operations, including for the purposes of marketing.
I HEREBY ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS "WAIVER AND RELEASE" AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE BLACK BELT ACAI, LLC, AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS AND ASSIGNS FROM AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST BLACK BELT ACAI, LCC FOR PERSONAL INJURY OR PROPERTY DAMAGE.
To the extent that statute or case law does not prohibit or release for ordinary negligence, this release is also for such negligence on the part of Black Belt Acai, LLC, its agents, and employees.
I agree that this Release shall be governed for all purposes by Alabama law, without regard to any conflict of law principles. This Release supersedes any and all previous oral or written promises or agreements.
In the event that any damage to equipment, facilities, or personnel occurs as a result of my or my family's or agent's willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any such actions of neglect or recklessness.
THIS WAIVER AND RELEASE OF LIABILITY SHALL REMAIN IN EFFECT FOR THE DURATION OF MY PARTICIPATION IN THE ACTIVITY, DURING THIS INITIAL AND ALL SUBSEQUENT EVENTS OF PARTICIPATION.
BY SIGNING, I ACKNOWLEDGE AND AGREE THAT I HAVE READ AND UNDERSTAND THIS DOCUMENT IN ITS ENTIRETY AND AM AGREEING TO BE BOUND BY THE PROVISIONS AS LAID OUT THEREIN. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS.
Signed by on {sign_date}