Unlimited Membership

Release and Indemnification Agreement

This document contains both a release agreement and an indemnification agreement. Please read carefully before signing.

All of the following terms of this Release and Indemnification Agreement were agreed to by:

Name: {name}

DATE: {sign_date}

I hereby acknowledge that I have voluntarily applied to participate in or receive martial arts instruction and training from Maelstrom South JiuJitsu LLC, Scott Marler, Michael Tiefenauer or persons selected by them.

I am aware that my participation and involvement in martial arts instruction, training and activity can be physically demanding and potentially hazardous to me. I further understand that serious injury and even death can occur to persons who participate in receive martial arts training, instruction and activity. With this awareness in mind, I agree to assume all of these risks and to bind myself, my heirs, next of kin, assigns and personal representatives to the terms of the Release and Indemnification Agreement.

Release Agreement for injuries and damages caused by negligence

In consideration of being permitted to participate in and receive martial arts instruction, training and activity by and with Maelstrom South JiuJitsu LLC, Scott Marler, Michael Tiefenauer or any persons chosen by them, I, for myself and personal representatives, heirs, assigns and next of kin, hereby release, waive and discharge Maelstrom South Jiujitsu LLC, Scott Marler, Michael Tiefenauer or any employees or agents (collectively ‘Released Parties’) from all claims and liability to me, my personal representatives, assigns, heirs and next of kin on account of injury to my person or property caused by the negligence of the Released Parties and arising out of:

A) My participating in martial arts instruction, training or activity with the released parties, including claims based upon or alleging injury or damage due to the Released Parties providing me unreasonable, imprudent, inadequate, improper or ineffective martial arts instruction; and

B) My use of the facilities or any instrumentality owned, possessed, leased controlled, maintained or used by any of the Released Parties for any purposes whatsoever.

Indemnification agreement

In consideration of being permitted to participate in and receive martial arts, instruction, training and activity by and with Maelstrom South Jiujitsu LLC, Scott Marler, Michael Tiefenauer or other persons chosen by them and understanding that by agreeing to the foregoing Release Agreement, it is my intention that I give up my right to sue, make claim against or seek damages from the Released Parties for injury to my person or property as specified above. I understand that, though I may be barred from making a claim against the Released Parties by virtue of the above Release Agreement, I may possibly be able to make claims against other persons or entities for such an injury to my person or property and that these other persons or entities, may, in turn, make a claim or file suit against one or more of the Released Parties. In such even, I, for myself and my heirs, assigns , personal representatives and next of kin, agree that if any claim is made, or suit is filed, against any of the Released Parties (including, but not limited to any claim for indemnity, partial indemnity or contribution) by reason of any injury to my person or property subject to the above Release Agreement, then I will defend, indemnify and hold harmless the Released Parties from all losses and expenses relating to such claim or suit and shall pay all costs, expenses and attorney’s fees that may be incurred by incurred by any of the Released Parties in defending such claim or suit and in enforcing the terms of this Release and Indemnification Agreement.

I herby expressly agree that this Release and Indemnification Agreement is intended to be as broad and inclusive as permitted by the laws of the state of Missouri and that if any portion of it is held invalid, I agree that the balance shall, notwithstanding, continue in full legal force and effect.

I have carefully read this Release And Indemnification Agreement and am aware of its contents. I am that this document is a binding contract between myself and Maelstrom South Jiujitsu LLC, Scott Marler, Michael Tiefenaur with legal consequences. I have signed it of my own free will.

In witness whereof, I have executed this Release and Indemnification Agreement on the day and year written herein.

__________________________________________ ________________

              (Signature)           (Date)