Trial Application

ATARAXIS BRAZILIAN JIU JITSU & SELF DEFENSE, LLC

General Release/Waiver of Liability and Indemnity Agreement

For and in consideration of being permitted to participate in any way or form in the Jiu Jitsu/Martial Arts Program indicated below and/or being permitted to enter for any purpose any restricted area (here in defined as any area where in admittance to the general public is prohibited), and otherwise intending to be legally bound, the undersigned participant, and/or the parent(s) and/or legal guardian(s) of a minor participant(s) named below {hereinafter referred to as “Individual(s)”}, hereby agrees as follows:

1. The Individual(s) understand, and the parent(s) and/or legal guardian(s) will instruct the minor participant(s), that, prior to participating in the below jiu jitsu/martial arts activity or event, he or she should inspect the facilities and equipment to be used, and, if he or she believes anything appears to be unsafe, the Individual(s) should immediately advise the officials/instructors of such condition and decline to participate. The Individual(s) understands and agrees that, if at any time, he/she believes that anything involved in the Program appears to be UNSAFE; he/she will immediately take all precautions to avoid the instruction area and DECLINE TO PARTICIPATE further.
2. The Individual(s)fully understand and acknowledge that:

1. There are inherent and obvious risks and dangers associated with participation in jiu jitsu/martial arts events and that participating in such events could result in disease, illness, bacterial infection(s), bodily injury, partial and/or total disability, paralysis and/or death.

1. The economic and non-economic losses and/or damages, which could result from said risks and dangers, as described above, could be severe.

1. Said losses and/or damages may be caused by the action, inaction or negligence of the participant or the action, inaction or negligence of others, including, but not limited to, the Releasees named below.

1. There may be other risks and/or dangers to the Individual(s) which are unknown and not reasonably foreseeable at this time.

1. The Individual(s) accepts and assumes such risks and responsibilities for said losses and/or damages resulting from such things, including, but not limited to, disease, illness, bacterial infection, injury, disability, paralysis or/death, however caused and whether caused in whole or in part by the negligence of the Releasees named below.
2. The Individual(s) does HEREBY REMISE, RELEASE, WAIVE, DISCHARGE the jiu jitsu/martial arts facility used by the participant(s), including it owners, managers, promoters, instructors, lessees of premises used to conduct the jiu jitsu/martial arts event or program, premises and event inspectors, underwriters, consultants and others who give recommendations, directions or instructions to engage in risk evaluation or loss control activities regarding the jiu jitsu/martial arts facility or events held at such facility and each of them, their directors, officers, agents, employees, {the “Releasees”}, his/her/its/their successors, assigns, heirs, executors and administrators from any and all manner of actions and causes of action, suits, debts, dues, accounts, bonds, covenants, contracts, agreements, judgments, claims and demands whatsoever in law or equity, including claims and demands or actions for injury, death, property damage, subrogation, contribution and/or indemnity of whatever nature, which may or could be brought against said Releasees, his/her/its/their successors, assigns, heirs, executors and administrators arising out of or relating in any way to the acts or omissions by the Releasees, before, during, or after the event(s).
3. The Individual(s) does HEREBY acknowledge that THE ACTIVITIES OF THE EVENT(S) ARE INHERENTLY DANGEROUS and involve the risk of serious injury and/

or death and/or property damage. He/She also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY ATTEMPTED RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES, for which he/she does further remise, release, waive and discharge any and all manner of actions and causes of action, suits, debts, dues, accounts, bonds, covenants, contracts, agreements, judgments, claims and demands whatsoever in law or equity, including claims and demands or actions for injury, death, property damage, subrogation, contribution and/or indemnity of whatever nature, which may or could be brought against said Releasees, his/her/its/their successors, assigns, heirs, executors and administrators, whatsoever.

1. The Individual(s) further expressly agrees that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the Province or State in which the event is conducted and that, if any portion is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

1. On behalf of the participant(s), individually, and the undersigned parent(s) and/or legal guardian(s) for the minor participant(s) executes this Waiver and Release. If, despite the Release, the participant makes a claim against any of the Releasees, the individual(s), parents(s) and/or legal guardian(s) will reimburse the Releasee for any money which they have paid to the participant, or on his/her behalf, and hold them harmless.

I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I MAY HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY, WITHOUT ANY INDUCEMENT, ASSURANCE, OR, GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

A. I agree that Flow State Yoga Therapy, LLC is in no way responsible for the safekeeping of my personal belongings while I
attend class. I understand that classes may be physically strenuous and I voluntarily participate in them with full
knowledge that there is risk of personal injury, property loss or death. Yoga is not a substitute for medical attention,
examination, diagnosis or treatment. Yoga is not recommended and is not safe under certain medical conditions. I affirm
that I alone am responsible to decide whether to practice yoga. I agree that neither I, my heirs, assigns or legal
representatives will sue or make any other claims of any kind whatsoever against Flow State Yoga Therapy, LLC, its
staff, private contractors or its members for any personal injury, property damage/loss, or wrongful death, whether
caused by negligence or otherwise.
B. If Participating in a Kids or Pre or Post Natal Classes
I individually and as parent and/or guardian of the minor child identified above hereby acknowledge the following notices
and grant to Flow State Yoga Therapy, LLC the following release from liability: I acknowledge and fully understand that I,
or my child, will be engaging in physical activities that may involve some risk of injury. I acknowledge and have been
advised that it is my responsibility to consult with my or my child’s physician with respect to any past or present injury,
illness, health problem or any other condition or medication that may affect my or my child’s participation. I assume the
foregoing risks and accept full personal responsibility for any personal injuries sustained by my child or myself which
might incur as a result or participating in this program and discharge and hold harmless Flow State Yoga Therapy, LLC,
its owners, directors, members, employees and agents from any claim, cause of action or liability for damages arising
from any personal injury to myself, my child or other persons or property caused by myself or my child’s participation in
yoga classes.
C. I acknowledge that all purchase policies, studio policies and terms of use are available with Flow State Yoga Therapy,
LLC and have been presented to me, any changes to these policies will be posted at this location

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Permission To Use Image/Photograph Subject: ATARAXIS Brazilian Jiu Jitsu & Self Defense, LLC, Academy/School/Events

I grant to Ataraxis Brazilian Jiu Jitsu & Self Defense, LLC, its representatives, directors, officers, agents, employees, his/her/its/their successors, assigns, heirs, executors and administrators the right to take photographs of me and my property in connection with the above-identified subject.

I authorize Ataraxis Brazilian Jiu Jitsu & Self Defense, LLC, its assigns and transferees to copyright, use and publish without compensation to me my image/photograph in print and/or electronically.

 I agree that Ataraxis Brazilian Jiu Jitsu & Self Defense, LLC may use without compensation to me such images/photographs of me, my children and/or my property with or without name(s) and for any lawful purpose, including but not limited to, such purposes as publicity, illustration, advertising, and Web content.

 I do not agree agree that Ataraxis Brazilian Jiu Jitsu & Self Defense, LLC may use without compensation to me such images/photographs of me, my children and/or with or without my name. Should we be in pictures or videos, we agree to have our faces covered with emojis or other pictures to remove our likeness. 

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.

Ataraxis Brazilian Jiu Jitsu & Self Defense, LLC has put in place preventative measures to reduce the spread of COVID-19; however, Ataraxis Brazilian Jiu Jitsu & Self Defense, LLC cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending a Ataraxis Brazilian Jiu Jitsu & Self Defense, LLC class or event could increase your risk and your child(ren)’s risk of contracting COVID-19.

By approving this waiver, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending an Ataraxis Brazilian Jiu Jitsu & Self Defense, LLC class or event and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at Ataraxis Brazilian Jiu Jitsu & Self Defense, LLC may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Ataraxis Brazilian Jiu Jitsu & Self Defense, LLC employees, volunteers, staff,  program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance or participation in an Ataraxis Brazilian Jiu Jitsu & Self Defense, LLC class or event (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless Ataraxis Brazilian Jiu Jitsu & Self Defense, LLC, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of Ataraxis Brazilian Jiu Jitsu & Self Defense, LLC, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Ataraxis Brazilian Jiu Jitsu & Self Defense, LLC class or event.