Common Sense Self Defense Waiver Form

I hereby acknowledge and agree to the following as a condition of my participation in the Safety and Self-Defense Workshop (the “Workshop”). 

 

I understand that the Workshop will require participants to participate in physical activity related to martial arts. Participants will actively engage in physical training exercises that may include, but limited to, close quarter combative training drills, ground fighting, joint manipulations, application of pressure points, achieving physical control over others, weapon protection, throws, falls and scenario simulations. The training may require participants to use training equipment and actively engage in close quarter street defense or combat exercises. I additionally understand that I may experience emotional or mental stress as a result of my participation in the training.  Notwithstanding my awareness that certain risks and dangers exist and may occur during this training, I still wish to participate. I additionally certify that I have no condition, whether mental or physical, that would prevent me from participation.

  1. My involvement and/or participation in the Workshop is voluntary, and I/or/my child, is acting under myself/or/my permission, and own free will.
  2. I understand that there is a risk of danger, bodily harm, injury, emotional stress or death as a result of my/or/my child’s participation.
  3. There is a potential for risks and dangers that may not be obvious or reasonably foreseeable at this time.
  4. I/or/my child do/does not have any medical ailments, physical limitations, or mental disabilities that will affect my/or/my child’s ability to participate in the Workshop.
  5. I understand this Workshop has been designed to provide me/or/my child with the safest and most effective way to survive and escape a physical assault. However, I understand that the instructors cannot guarantee my safety through the use, or misuse, of the techniques taught in Workshop.
  6. Common Sense Self Defense (AKA Nichelle Laus and Kevin Smith)  and/or the Instructor in charge undertakes no direct legal or financial responsibility for my/or/my child’s personal safety or wellbeing when I/or/my child is participating in this Workshop.
  7. I assume the risks, including but not limited to those outlined above in sections 1 through 5 of this agreement.
  8. I forever release Common Sense Self Defense (AKA Nichelle Laus and Kevin Smith), and its Instructors and all related participants, from any and all claims and causes of action that I/or/my child’s representatives now or may have in the future for personal injury, property damage or wrongful death occurring to me/or/my child, arising out of participation in this Workshop.
  9. I am 100% liable for all medical expenses incurred as a result of any injury or property damage during my/or/my child’s participation in this Workshop.
  10. In consideration for the right to participate in this training, 

I UNDERSTAND AND DO HEREBY AGREE TO ASSUME ALL OF THE ABOVE RISKS AND OTHER RELATED RISKS WHICH MAY BE ENCOUNTERED DURING THE TRAINING, INCLUDING ACTIVITIES IN PREPARATION OF AND/OR SUBSEQUENT AND RELATED TO THE TRAINING

Accordingly, I on behalf of my heirs, assignees, and/or successors, do hereby agree to hold Common Sense Self Defense (AKA Nichelle Laus and Kevin Smith), its directors, agents and employees harmless from any and all liability, actions, causes of actions, claims, expenses, and damages on account of injury to my person or property, even injury resulting in death, which I now have or which may arise in the future in connection with my participation in the Training Workshop and in my use of the training equipment provided. 

  1. In the event that any one or more of the provisions of this agreement shall be held to be invalid, illegal, and enforceable or in conflict with the law according to the jurisdiction, of the Province of Ontario, Canada the remaining portions will not be invalidated, and shall remain in full force and effect.
  2. This is a legally binding contract, but it is not meant to pronounce any claims or defenses that are legally prohibited. 

 

I attest that I have read and understand this document, and agree to all provisions listed above. 

 

By signing this waiver, I agree to the above terms and conditions.

 

Children under 16 will require parent/guardian signature.