I
(enter name)
_____________________________,
hereby make application for membership in the WORLD GUAZABARA
FEDERATION™ (WGF), Warrior Way, Inc. and upon acceptance, I sincerely
pledge to obey all rules and regulations as set forth in the WGF,
WARRIOR WAY, INC. Constitution and By-Laws and by the President and
Board of Directors. I clearly recognize that a risk is involved in the
studying of the martial arts, and related activities, which has been
completely explained to and/or understood.
I further warrant and represent
that I am in good physical condition and that I have no disability or
ailment which may prevent me from engaging in active or passive exercise
or that will be detrimental to my health, safety or physical condition
if I engage or participate in such exercise and/or other activities
conducted by the WGF, WARRIOR WAY, INC. at any facility designated as a
training center by WARRIOR WAY, INC. I further warrant that if I have a
prior history of disability, impairment or ailment and engage or
participate in such exercise and/or activities conducted by the WGF,
WARRIOR WAY, INC OR ANY WARRIOR WAY, INC. TRAINING FACILITY, I do so at
my own risk.
I FURTHER ACKNOWLEDGE THAT
PHYSICAL EXERCISE IS A POTENTIALLY DANGEROUS ACTIVITY AND THAT I AM
VOLUNTARILY PARTICIPATING IN THE ACTIVITIES SPONSORED BY THE WGF,
WARRIOR WAY, INC WITH THE KNOWLEDGE OF THE DANGERS INVOLVED THAT
INCLUDE, BUT ARE NOT LIMITED TO, SOFT TISSUE INJURIES SUCH AS, MUSCLE
STRAINS, TORN LIGAMENTS, BROKEN BONES, PHYSICAL EXHAUSTION,
OVER–EXERTION, FALLS AND PHYSICAL CONTACT WITH OTHER PARTICIPANTS AND
ASSOCIATES AND USERS OF THE FACILITIES. KNOWING AND APPRECIATING THESE
RISKS, I HEREBY AGREE TO ACCEPT ALL RISK OF INJURY OR DEATH.
I EXPRESSLY AGREE AND UNDERSTAND
THAT WARRIOR WAY, INC. SHALL NOT BE LIABLE FOR ANY INJURY OR DAMAGE
SUSTAIN FROM THE NEGLIGENCE OR OTHER ACTS, HOWEVER CAUSED, BY ANY
EMPLOYEE, AGENT OR CONTRACTOR OF WARRIOR WAY, INC. OR THAT OCCURS AS A
RESULT OF MY USE OR INTENDED USE OF THE FACILITIES AND/OR EQUIPMENT OF
WARRIOR WAY, INC., EVEN THOUGH THAT LIABILITY MAY ARISE OUT OF THE
NEGLIGENCE OR CARELESSNESS ON THE PART OF THE PARTIES NAMES IN THE
PARAGRAPH.
By execution of the Agreement and
Release of Liability, I assume for myself, or for anyone entitled to act
on my behalf, or anyone on whose behalf I am entitled to act, full
responsibility for any and all injury and/or damage that may occur to me
in connection with the WGF, WARRIOR WAY, INC. I further agree that WGF,
WARRIOR WAY, INC. and its employees, agents and contractors, or any of
them, shall not be liable for theft or loss of my personal property. On
behalf of myself, my heirs, my attributes, my guardians, my legal
representatives and my assigns, I fully and forever release and
discharge the WGF, WARRIOR WAY, INC. and its employees, agents,
contractors, attendants, successors and assigns, or any of them, from
any and all claims, liabilities, demands and causes of action whether
the same be known or unknown, anticipated, resulting or arising from my
use or intended use of the WGF, WARRIOR WAY, INC.
I further understand that WGF,
WARRIOR WAY, INC. does not carry medical insurance and that to do so
would make the cost of WGF, WARRIOR WAY, INC. prohibitive. I understand
and fully agree that I am responsible for my own medical insurance and
health care and realize that martial arts, Police Combatives and 1st
Responder Defensive Tactics training IS A POTENTIALLY
DANGEROUS ACTIVITY. KNOWING THIS, I VOLUNTARILY AGREE TO PARTICIPATE IN
THE TRAINING ACTIVITIES SPONSORED BY WARRIOR WAY, INC. I AGREE TO
ACCEPT ANY AND ALL RISKS OR INJURY RELATED TO SUCH TRAINING AND FULLY
UNDERSTAND THAT I AM RESPONSIBLE FOR MY OWN MEDICAL INSURANCE.
I AM OF FULL AGE AND HAVE THE
RIGHT TO CONTRACT IN MY OWN NAME. I HAVE CAREFULLY READ THIS AGREEMENT
AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF
LIABILITY AND CONTRACT BETWEEN WARRIOR WAY, INC. AND MYSELF. I SIGN
THIS AGREEMENT OF MY OWN FREE WILL AND WITH ALL MY FACULTIES AND THIS
SHALL BE BINDING UPON MY HEIR, ASSIGNS, SUCCESSORS, AND LEGAL
REPRESENTATIVES.
______ : PLEASE PLACE X HERE IF
THIS APPLICATION IS BEING SUBMITTED ONLINE
___________________________________________________
Member
** Print & Mail to: World Guazabara
Federation HQ, 14 E. Wilson St. Batavia,
IL 60506 USA
Please submit the appropriate
application fee and make all checks payable to
Warrior Way, Inc.