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I, {name} - Full name, understand and recognize that Jiu-Jitsu, Wrestling, Judo, MMA, Boxing, Strength & Conditioning, Yoga, and any other martial arts form not listed is a physically demanding activity and a sport that involve physical contact and risk of physical injury and that is taught using all precautions to avoid any injuries to myself or others. With all precautions made, you release Haan Palcu-Chang and Birinder Kahlon, their agents, and employees, that you, the member or guardian of the member or participant, shall indemnify and hold harmless Haan Palcu-Chang and Birinder Kahlon for all claims and causes of action. I, signing on behalf of myself or as guardian, hereby release and waive, hold harmless, and indemnify Haan Palcu-Chang and Birinder Kahlon, their employees, or agents from legal actions, claims, suits, expenses (medical or attorney fees).

I understand, on behalf of myself or as guardian of the member participating in activities that Haan Palcu-Chang and Birinder Kahlon offer that negligence of any kind, either known or foreseen, and with such damages, injury, paralysis, loss, or death results will not show negligence acted upon by Haan Palcu-Chang and Birinder Kahlon.

I understand, agree, and abide that I, as the participant, member or guardian of the participant and member, understand and will not act on any legal action, claim or lawsuits of any kind against Haan Palcu-Chang and Birinder Kahlon as a result of bodily injury, paralysis, and death inside the facility or within 500 yards of the facility in which training takes place.

With full knowledge of the aforementioned dangers, both to my person and my property (current and future), and after fully explaining these dangers to myself and/or to my legal guardian.

I, member or guardian of the member, give access and grant Haan Palcu-Chang and Birinder Kahlon, their employees or representatives, to take photos of me and my property and to publish and/or copyright them on behalf of Haan Palcu-Chang and Birinder Kahlon. I also allow Haan Palcu-Chang and Birinder Kahlon to publish, post, or use photography and videos with or without my name for advertising, illustrations, publishing, or publicity.

I hereby certify and declare that I will release and forever hold free and discharged from any liability Haan Palcu-Chang and Birinder Kahlon and each of their agents, stockholders, directors, officers, employees, and representatives of and from all claims, demands, rights and causes of action of any nature whatsoever which may have or which may hereafter accrue to me, arising from and because of any and all bodily or personal injury, damage to property or loss and any consequence thereof, whether known or unknown, seen or unforeseen, resulting from any participant in Haan Palcu-Chang and Birinder Kahlon, their persons and entities mentioned above.

It is further understood that this waiver, release and assumption of risk is forever binding on my heirs or assigns.

My signature on this document is evidence that I know and understand, and have had this document explained to me, that I fully understand the dangers inherent in participating at Haan Palcu-Chang and Birinder Kahlon. I agree to the terms and conditions of this waiver form. I agree with the policies applied for all students of Haan Palcu-Chang and Birinder Kahlon presented at the time of registration and the implementation of future changes.

Please sign Here to Agree to the terms and conditions of this Waiver Form:

Parent/Guardian Signature if under 18 years of age

- Name of the member or guardian signing the document (if applicable)