Waiver
THIS AGREEMENT MUST BE SIGNED BY ALL MEMBERS WHO WISH TO PARTICIPATE IN ANY SANCTIONED
ACTIVITY OR EVENT OF THE CENTRAL KANSAS DREAM CENTER (CKDC) OR NOVERMBER TANGO MARTIAL ARTS (NTMA)
In consideration of being allowed to participate in any way in the sanctioned events of CKDC/NTMA, I,
____________________________________:
1. Recognize and understand that martial arts training is a physical contact activity and that my participation might
result in serious injury, including permanent disability or death, and severe social and economic loss.
2. Recognize and understand that such risk may be due to, not only, my actions, but also the action, inaction, or
negligence of others, the regulations of participation, or the conditions of the premises, or of any of the
equipment used.
3. Recognize that there may be other risks that are not known to me or to others or not reasonably foreseeable at this
time.
4. Agree to inspect the facilities, equipment, and pairings prior to participation. I will immediately inform an
instructor of the CKDC/NTMA if I believe that anything is unsafe or beyond my capability and refuse to participate.
5. Assume all the forgoing risks and accept personal responsibility for any damages that may result from injury,
permanent disability, or death.
6. Enter martial arts training and/or competition entirely of my of my own free will and understand the importance of
following the rules of training and competition. I have been given a copy of the rules and regulations of the
CKDC/NTMA and agree to abide by the instructions given therein.
7. I certify that I am in good physical condition, and have no disease, injury, or other condition that would impair my
performance or physical and mental well-being during intense training, practice, and/or competition.
8. Grant permission in case of injury to have a doctor, nurse, athletic training, or other emergency medical personnel
provide me with medical assistance or treatment for such injury.
9. I, my family members, respective legal representatives, heirs and assigns hereby release, waive and discharge the
CKDC, Phoenix Dream Center, NTMA, affiliated organizations and national governing bodies, their officers, instructors
and personnel, other members of the organizations, participants, supervisors, coaches, sponsoring organizations or
their agents, and if applicable, premises owners, lessors, and lessees (collectively “Releasees”) from all liability to the
undersigned for any and all loss or damage, and any claim for damages resulting therefrom, on account of injury, even
injury resulting in death, whether caused by negligence of any of the Releasees, or otherwise, while utilizing the
instruction, equipment, premises, buildings, and facilities of the Releasees and otherwise participating in any activities
of the Releasees.
10. I agree to indemnify and hold harmless the Releasees from and against any liability to any individual, incident to
any injury, including injury resulting in death, sustained by the individual caused by my participation in the activities
of the Releasees, or otherwise, while utilizing the instruction, equipment, premises, buildings, and facilities of the
Releasees.
11. I expressly agree that the release, waiver and indemnity provisions of this agreement are intended to be as broad
and inclusive as permitted by the Laws of the State of Kansas, and that if any portion thereof is held invalid, it is
agreed that the rest of this agreement shall continue in full force and legal effect.
I HAVE READ THE ABOVE WARNING, WAIVER, RELEASE, AND AGREEMENT TO PARTICIPATE. I
UNDERSTAND ITS CONTENTS AND DO HEREBY SIGN IT VOLUNTARILY.
