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WAIVER, RELEASE & INDEMNIFICATION AGREEMENT

In consideration of permitting the undersigned (“Applicant”) to use the premises and facilities of Procel Martial Arts and Fitness, LLC d/b/a Procel Brazilian Jiu-Jitsu (“Provider”) for training and instruction in the art of Brazilian Jiu-Jitsu and related activities (“Service”) the following Applicant agrees upon and acknowledges Applicant shall be bound by the following terms and conditions:

Acknowledgment of Inherent Risks: I, the Applicant, have been advised and understand that the practice of martial arts is potentially dangerous. It is understood that due to the nature of the training which is being provided by the Provider that accidents from time to time occur. While all the precautions will be taken to assure the safety of all students, it is impossible to guarantee that such accidents will not occur. I acknowledge that there are risks and dangers associated with participation in Jiu-Jitsu classes, training and related activities which could result in property damage, bodily injury, partial or total disability, paralysis or death. I further acknowledge that the social and economic losses and/or damages, which could result from the above-described risks and dangers could be severe. Said risk and dangers may be caused by the action, inaction or negligence of the Applicant, other students, or persons under the control of the Provider. There may be additional risks and dangers, not known or foreseeable at this time.

Medical Conditions: The Applicant declares that he or she is physically fit. Applicant further states that he or she is not currently aware of any health problems, physical impairments, injuries or medical conditions that. In the interests of your safety and the safety of others, the Provider should be advised of. The Applicant warrants that he or she has not at any time suffered any blackout, seizure, convulsion, fainting, or dizzy spells and is not presently receiving treatment for any illness, disorder or injury which would render it unsafe for the Applicant to take part in Martial Arts in general or the aforementioned Services. I further authorize medical treatment for myself, at my cost, if the need arises.

Exclusion of Applicant: The Applicant warrants that he or she has not at any time been excluded from a martial arts class by a medical practitioner or any person or entity, including, without limitation a martial arts school, health club or similar facility that offers physical training.

Waiver and Indemnification: In consideration of the acceptance of my participation and enrollment in Provider’s Jiu-Jitsu School, I agree to assume the risks incidental to such participation (which risks may include, among other things, damage to property, muscle, injuries, broken bones, loss of consciousness or death) and, on my own behalf, and behalf of my heirs, dependents, executors, and administrators, release and forever discharge, to the full extent permitted by law, Providers, and its officers, owners, instructors, employees, agents, servants contractors and other students, or persons under Provider’s control (“Released Parties”), of and from all liabilities, claims, actions, damages, costs or expenses of any nature arising out of or in any way connected with my participation in such activity and further agree to absolve, indemnity and hold each of the Released Parties harmless against any and all such liabilities, claims, actions, damages, costs or expenses, including but not limited to, attorney’s fees and related disbursements. I acknowledge and fully understand that this release and indemnity agreement includes any claims based on the negligence, action or in-action of any of the above Released Parties and covers bodily Injury (including death) and property damage, whether suffered by me, before, during, or after such participation. I have read this agreement, fully and understand its terms, understand that I have given up substantial rights by signing it and have freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of liability to the greatest extent allowed by the law and agree that if any portion of this agreement is held to be invalid that the balance, notwithstanding, shall continue in full force and effect.

Governing Law: This agreement shall be governed by and construed in accordance with the laws of the State of New Jersey, without regard to the conflicts of law provisions thereof.

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

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APPLICANT FULL NAME                                             DATED