Blue Dragon Judo Club

WARNING!

WAIVER AND RELEASE OF LIABILITY AND AGREMENT TO PARTICIPATE

 

In consideration of being permitted to participate in any way, including travel to and from, in any judo tournament, practice, clinic, and related events and activities of United States Judo, Inc., United States Judo Federation, United States judo Association, Connecticut Judo, Inc., Blue Dragon Judo Club, Middletown Public Schools, and Middletown Park and Recreation Dept., I hereby:

 

  1. Acknowledge that I am familiar with the sport of judo and understand the rules governing the sport of judo.
  2. Agree that prior to participating, I will inspect the mats, equipment, facilities, competition pool or divisions and the elimination or scoring system to be used, and if I believe anything is unsafe or beyond my capability, I will immediately advise my coach, supervisor, and/or a tournament official of such conditions and refuse to participate.
  3. Acknowledge and fully understand that I will be engaging in a contact sport that might result in serious injury, including permanent disability or death, and severe social and economic losses due to not only my own actions, inactions, or negligence, but also to the actins, inactions, or negligence of others, the rules of the sport of judo, or conditions of the premises or of any equipment used.  Further, I acknowledge that there may be other risks not known to me or not reasonably foreseeable at this time.
  4. Knowing the risks involved in the sport of judo, I assume all such risks and accept personal responsibility for the damages following such injury, permanent disability, or death.
  5. Release, waive, discharge and covenant not to sue the United States Judo, Inc., United Status Judo Federation, United States Judo Association, Connecticut Judo, Inc., Blue Dragon Judo Club, Middletown Public Schools, and Middletown Park and Recreation Dept. together with their affiliated clubs, their respective administrators, directors, agents, coaches and other employees or volunteers of the organization, event officials, medical personnel, other participants, their parents, guardians, supervisors and coaches, sponsoring agencies, sponsors, advertisers, and if applicable, owners, lessors, and lessees of premises used to conduct the event(s), all of whom are hereinafter referred to as “releasee,” from any and all claims, demands, losses, or damages on account of injury, including permanent disability and death and damage to property, caused or alleged to be caused in whole or in part by the negligence of the release or otherwise to the fullest extent permitted by law.

 

Text Box: I HAVE READ THE ABOVE WARNING, WAIVER AND RELEASE, AND UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND KNOWING THIS, SIGN IT VOLUNTARILY. I AGREE TO PARTICIPATE KNOWING THE RISK AND CONDITIONS INVOLVED AND DO SO ENTIRELY OF MY OWN FREE WILL. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENT/GUARDIAN AS EVIDENCED BY THEIR SIGNATURE BELOW.

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Participant’s Printed Name                                 Participant’s Signature                                        Date

Text Box: FOR PARENTS/GUARDIANS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION)

 

This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release, as provided above, of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above, even if arising from their negligence, to the fullest extent permitted by law.  I have instructed the minor participant as to the warnings and conditions and their ramifications.

 

 

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Parent’s Printed Name                                       Parent’s Signature                                              Date