ACKNOWLEDGEMENT AND RELEASE FORM
I, the applicant, on behalf of myself, members of my family, my heirs, executors, administrators and assigns, hereby forever release, discharge and hold harmless GROUND DWELLERS, LLC. representatives and agents for any injury, loss or damage to my person or property howsoever caused, arising out of or in connection with my taking part in Martial Art Classes, Self Defense Seminars and activities and notwithstanding that the same may have been contributed to or occasioned by the negligence of GROUND DWELLERS, LLC, representatives or agents.
Please note: Participants must supply their own protective equipment.
The undersigned acknowledges that:
1. He/She is desirous of using, as a member on a membership basis, the Martial Arts School herein referred to as
“GROUND DWELLERS, LLC”
2. He/She has received a completely executed copy of this agreement.
3. He/She confirms that there were no verbal presentations other than those specified in this agreement.
4. He/She may be photographed or filmed while attending at the premises of GROUND DWELLERS, LLC and he/she gives
permission to GROUND DWELLERS, LLC, and any affiliates to use any and all photos, video footage, and/or video
streaming for promotional, sales, publicity, and advertising purposes for all media including internet.
5. The waiver was read and he/she agrees to abide by it.