Membership Waiver of Release

BEFORE WE CAN PROCESS YOUR APPLICATION, YOU MUST ACKNOWLEDGE THIS INFORMATION.
PLEASE READ COMPLETELY BEFORE ENTERING YOUR DIGITAL SIGNATURE BELOW.

Membership Release & Waiver (July)

IN CONSIDERATION OF MEMBERSHIP GRANTED ME OR MY SON/DAUGHTER BY UMMAF. (aka KICK INTERNATIONAL) TO PARTICIPATE AS AN AMATEUR IN ANY MARTIAL ARTS APPROVED OR SANCTIONED EVENTS INCLUDING KICKBOXING OR MIXED MARTIAL ARTS OF ANY KIND, DURING MY OR HIS/HER TENURE. I, THE UNDERSIGNED, TAKE THE FOLLOWING ACTION FOR MYSELF, MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, SUCCESSORS MY PERSONAL REPRESENTATIVE AND ASSIGNS: I agree that: A) I WAIVE, RELEASE, AND DISCHARGE FROM ANY AND ALL CLAIMS OR LIABILITIES FOR DEATH OR PERSONAL INJURY OR DAMAGES OF ANY KIND, EXCEPT THAT WHICH IS THE RESULT OF GROSS NEGLIGENCE AND/OR WANTON MISCONDUCT OF PERSONS OR ENTITIES LISTED BELOW, WHICH ARISE OUT OF OR RELATED TO MY PARTICIPATION IN, OR MY TRAVELING TO AND FROM A MARTIAL ARTS EVENT, MMA, OR KICKBOXING EVENT OR SUPERVISED PRACTICE. THE FOLLOWING PERSONS OR ENTITIES: KICK INTERNATIONAL AND ITS RECOGNIZED CERTIFIED CLUB; EVENT FACILITIES; THE TOURNAMENT DIRECTORS; SPONSORS; OFFICIALS; COACHES; EVENT PHYSICIANS AND THE OFFICERS, DIRECTORS, EMPLOYEES, REPRESENTATIVES, AND EMPLOYEES, REPRESENTATIVES AND AGENTS OF ANY THE ABOVE; and B) I AGREE NOT TO SUE ANY OF THE PERSONS OR ENTITIES MENTIONED ABOVE FOR ANY OF THE CLAIMS OR LIABILITIES THAT I HAVE WAIVED, RELEASED OR DISCHARGED HERIN; and C) I INDEMINIFY AND HOLD HARMLESS THE PERSONS OR ENTITIES MENTIONED ABOVE FROM ANY CLAIMS MADE OR LIABILITIES ASSESSED DURING MY PRESENCE OR PARTICIPATION. I WILL REMOVE MYSELF FROM PARTICIPATION AND BRING SUCH TO THE ATTENTION OF THE NEAREST OFFICIAL IMMEDIATELY. D) I UNDERSTAND AND AGREE THAT ALL KICK INTERNATIONAL MEMBERS AND AFFILIATED MEMBERS, OFFICIALS, PARTICIPANTS AND THEIR GUESTS PARTICIPATE VOLUNTARILY AND AT THEIR OWN RISK IN ALL KICK INTERNATIONAL ACTIVITIES. E) I, THE UNDERSIGNED, FULLY UNDERSTAND THAT PARTICIPATION IN THE SPORT OF KIICKBOXING/MMA CARRIES A RISK TO ME OF SERIOUS INJURY INCLUDING PERMANENT PARALYSIS OR DEATH. I VOLUNTARILY AND KNOWINGLY WILL ABIDE BY ALL RULES, REGULATIONS AND DECISIONS OF KICK INTERNATIONAL AND RECOGNIZE, ACCEPT AND PERSONALLY ASSUME ANY AND ALL RISK. I ACKNOWLEDGE THAT I AM COMPETING AS AN AMATEUR AND CAN NOT AND WILL NOT ACCEPT ANY PAYMENT WHICH CAN BE RECOGNIZED AS A FEE OR PURSE TO COMPETE. IF I AM PAID TO COMPETE I ACKNOWLEDGE THAT I WILL NO LONGER BE CONSIDERED AS AN AMATEUR. *

I AGREE

WAIVER OF RIGHTS UNDER STATE STATUTE I further agree to waive all benefits flowing from any state statute which would negate or limit the scope of this Release and Indemnification Agreement including, but not limited to, Section 1542 of the California Civil Code which provides: “A general release does not extend to the claims which a creditor does not know or suspect to exist in his favor at the time of executing the release, which if known to him must have materially affected his settlement with the debtor”. *

I AGREE

ALL PARTICIPANTS: I CERTIFY THAT I HAVE HAD NO INJURIES TO MY HANDS, FEET, OR LEGS, NEITHER FRACTURES NOR BROKEN BONES, WHICH EXIST OR OCCURRED WITHIN THREE MONTHS PRECEDING THE DATE OF THE ATHLETE MEMBERSHIP APPLICATION FORM, AND KNOW OF NO INJURIES TO THE HEAD, CONCUSSION OR FAINTING SPELLS, I WILL NOTIFY MY COACH, TRAINER, OR OTHER LOCAL KICKBOXING OFFICALS IMMEDIATELY SHOULD ANY OF THESE INJURIES OR CONDITIONS BE EXPERIENCED IN THE FUTURE. I FUTHER AGREE THAT IF I DO EXPERIENCE ANY IF THE AFOREMENTIONED CONDITIONS OR INJURIES. I WILL IMMEDIATELY CEASE TRAINING, SPARRING AND COMPETING AS A KICKBOXER UNITL SUCH CONDITIONS OR INJURIES NO LONGER EXIST *

I AGREE

FEMALE PARTICIPANTS ONLY: I CERTIFY THAT I AM NOT PREGNANT, OR HAVE ANY PAINFUL PELVIC DISCOMFORT SUCH AS SYMPTOMIC ENDOMETRIOSIS OR OTHER CAUSES, ABNORMAL VAGINAL BLEEDING OF UNDETERMINED CAUSES (ETIOLOGY), RECENT LOSS OF MENSTRUAL PERIOD (SECONDARY AMENORRHEA), RECENT DEVELPOMENT BREAST MASS, RECENT BREAST DYFUNCTION PREVIOUSLY NOT PRESENT OR SURGICAL BREAST IMPLANTS, AND UNDERSTAND THE KICK INTERNATIONAL OFFICIAL RULES AND REGULATIONS PERTAINING TO MY PHYSICAL CONDITION. I FURTHER AGREE THAT I WILL IMMDEIATELY NOTIFY MY COACH, TRAINER, OR OTHER LOCAL KIICKBOXING/MMA OFFICIAL IF ANY OF THE ABOVE DESCRIBED CONDITIONS SHOULD DEVELOP/APPLY. *

I AGREE

DOES NOT APPLY TO ME - I'M A MALE

GOVERNING LAW. The parties expressly agree that this Agreement will be governed by, and construed and enforced exclusively to accordance with the laws of the State of Missouri, USA. Parties further agree that the State of Missouri shall have exclusive jurisdiction over the parties in any proceedings based upon or arising out of all or any portion of this agreement, or disagreement between parties. DISPUTE RESOLUTION. Arbitrable Claims. All claims that UMMAF-KICK International and member may have against each other in any way related to the subject matter, interpretation, Event, or alleged breach of the Agreement ("Arbitrable Claims"), on the written demand of either parties hereto. shall be submitted to and be determined by final and binding arbitration held in St Louis, Missouri, in accordance with the rules of the American Arbitration Association. The fees of the arbitrator shall be split between both parties equally. The Parties hereby waive any and all rights they may have to trial by jury with regard to any claims or disputes. The parties agree that this Paragraph shall survive termination of this agreement. THIS MEMBERSHIP AGREEMENT CONTAINS A BINDING ARBITRATION PROVISION WHICH MAY BE ENFORCED BY THE PARTIES. *

I AGREE

FIRST NAME

LAST NAME

YOUR ACKNOWLEDGEMENT BY THIS ELECTRONIC SIGNATURE COMPLETES YOUR MEMBERSHIP APPLICATION

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