CARRILLO MUAY THAI BOXING
TRAIN WITH JEAN CARRILLO WORLD CHAMPION COACH
$150.00 PER MONTH
15 DAYS REQUIRES TO CANCEL FOR NEXT MONTH
Carrillo Muay Thai Membership Waiver / Contract Agreement and Release of Liability In consideration of being allowed to participate in the activities and programs of Carrillo Muay Thai and use of facilities and equipment.
I the Member do hereby waive, release and forever discharge Carrillo Muay Thai and its officers, members, agents, employees, representatives, executors, and all others from any and all responsibilities or liabilities from injuries or damages resulting from my participation in any activities or my use of equipment and facilities in the above mentioned Club.
I do hereby release all those mentioned and any others acting on their behalf from any responsibility or liability for any injury or damage to myself including those caused by the negligent act or omission of any of those mentioned or others acting on their behalf or in any way arising out of or connected with my participation in any activities of Carrillo Muay Thai or the use of any equipment at Carrillo Muay Thai.
I understand and am aware that thai boxing and full contact sports and participation in them is a potentially hazardous activity. I also understand that these activities involve risk of injury or even death, and that I am voluntarily participating in these activities.
It has been advised that I should make provisions for coverage of liability within my own insurance policy. I do hereby give the Carrillo Muay Thai and its designees the irrevocable right to use my photograph and or video imaging as a part of their printed material, social media, website and any promotional marketing advertisement.
I hereby waive all rights to approve the finished product. I also release Carrillo Muay Thai from any claims for compensation associated with any forms of damages, foreseen or unforeseen, associated with the use of the images or videos. ***If applicant is less than 18 years of age, a parent or legal guardian must read above application and give consent on the signature below:When signing this waiver you are agreeing to ALL policies, agreements, contract, waivers and price categories which apply to you and/ or minor you are singing for below.
I understand that there are risks and dangers in participating in martial arts activities and that in order to participate, in any such activities, including but not limited to Boxing, Kick Boxing, Muay Thai, MMA, and other martial arts classes/training, including classes/training involving the use of martial arts weapons, I must give up my rights to hold Carrillo Muay Thai and any other entity or charity associated with Carrillo Muay Thai, responsible or liable for any damage that I may suffer while participating in such classes/training provided by Carrillo Muay Thai, waiting at or on Carrillo Muay Thai premises to participate in such classes/training, walking through the premises at Carrillo Muay Thai prior to or after such classes.
Knowing this and in consideration for being permitted to participate in martial arts classes/training with Carrillo Muay Thai, I hereby voluntarily forever release, discharge and hold completely harmless Carrillo Muay Thai, and all other entities or charities associated with Carrillo Muay Thai, and their members, offices, students, directors, agents, employees, heirs, assigns and independent contractors from any and all responsibility for, or liability resulting from or arising from, my participating in martial arts classes/training at Carrillo Muay Thai, and being on the premises at Carrillo Muay Thai.
I understand that the martial arts classes provided at Carrillo Muay Thai may included, but will not be limited to, activities such as kicking, punching, hitting, stretching, twisting, jabbing, lunging, rolling, falling, jumping, yelling, hand locks, and the use of various martial arts weapons and equipment.
I realize that these activities, as well as all other martial arts activities, can be dangerous, but I am voluntarily choosing to participate in some or all of these activities and agree to assume the risk associated with my participation therein.
I understand that I am assuming full responsibility for any and all risks of death, personal injury, emotional pain and suffering, property damage and economic loss that might be suffered by me as a result of my participation in martial arts classes at Carrillo Muay Thai.
I agree that this release shall bind me, my spouse, my heirs, my personal representatives, my assigns, my children and my and their agents.
I hereby further agree to release, indemnify and hold completely harmless Carrillo Muay Thai, and all other entities associated with Carrillo Muay Thai, and their members, officers, directors, agents, employees, heirs, assigns and independent contractors harmless from any and all liability and costs, including attorney fees, associated with or arising from my participating in martial arts classes/training at Carrillo Muay Thai, waiting at or on Carrillo Muay Thai premises to participate in such classes/training, and walking through the premises at Carrillo Muay Thai prior to or after such classes/training.
I understand that if I were to file a law suit against Carrillo Muay Thai, or any other entity associated with Carrillo Muay Thai and/or their members, officers, directors, agents, employees, heirs, assigns and independent contractors, as a result of any personal injury including death, emotional pain and suffering, property damage or economic loss suffered by me as a result of my participation in martial arts classes/training at Carrillo Muay Thai, waiting at or on Carrillo Muay Thai premises to participate in such classes/training, and walking through the premises at Carrillo Muay Thai prior to or after such classes/training, that this release would bar the lawsuit and the court would dismiss it on the grounds that by signing this release.
I have expressly assumed all the risks associated with participation in such activities, including but not limited to negligence on the part of the martial arts instructors in the performance of their duties, negligence by other members of Carrillo Muay Thai, negligence in the operation of machinery or equipment, and/or premises liability.
If I am signing this release on behalf of a minor child, I understand that I am giving up the same rights for the said minor as if I signed this release on my own behalf. I have read this agreement and understand the words and language in it and I am advised of all potential dangers incidental to participation in martial arts classes/training at Carrillo Muay Thai, including travel to and from.
I agree that this is a document consisting of a total of one page and that I have been presented, have read and understood the contents contained herein and the rights that I am giving up by signing below where indicated.
Month to Month Contract $150.00 per month renew every month exept if cancel 2 weeks before next payment
Carrillo Muay Thai Recurring Billing Authorization (AUTO RENEWING) I hereby authorize Carrillo Muay Thai to perform scheduled charges/debits from the indicated credit card/bank account.
I agree that this is a continuing monthly charge that will begin on the enrollment date that will be made every 30 days.
I understand that to terminate the recurring billing process, I agree to notify Carrillo Muay Thai in writing (not verbally, via email or phone message) of any changes in my account information or termination of this authorization 15 days prior to the next due date of the charges/ debits pre-authorized by this form and arrange for an alternative method of payment.
I understand that cancellations must be made in writing and I will not dispute Carrillo Muay Thai recurring billing with my credit card issuer/bank so long as the amount corresponds to terms indicated in this contract.
I understand that if I do not cancel my membership in writing 15 days in advance or fail to pay my balance that I will be sent to collections.
I also understand that if cancellation is made less then 15 days in advance, my account will be debited my final payment upon cancellation.
I guarantee and warrant that I am the legal cardholder/duly authorized check signer on the above account(s), and that I am legally authorized to enter into this recurring billing agreement with Carrillo Muay Thai.
All changes require a 15 day notice prior to Auto-Debit Cycle Day and All changes must be made in writing and mailed or dropped off to Carrillo Muay Thai.
By Signing bellow I agree with this term: