{name}
{dob}
This agreement between the United Martial Arts Ltd. hereinafter referred to as instructor and the student named above hereinafter referred to as member. The instructor shall not be liable for any damage arising from personal injuries sustained by the member in, on, or about the premises of any one of the said Instructor’s facilities and equipment therein, does so at his or her own risk. Member assumes full responsibility for any injuries or damages which may occur to the member in, on, or about the premises of said facilities and he or she does hereby fully and forever release and discharge the Instructor and all his employees and agents from any and all demands and damages, rights of action or cause of action, present or future, where the same be known or unknown, anticipated or unanticipated, resulting from or arising out of the member’s use or uninvited use of the said gymnasium of facilities, service, instruction and equipment thereof, including, but not without limitations, any claims for personal injury resulting from or arising of the negligence of the Instructor, the gymnasium, or their owners, agents and employees, or the agents and employees of the Instructor and the negligence of any persons present at said premises including other persons using the said premises as members.
{sign_date}
