Schedule

LIC Judo — Waiver and Release of Liability

This Participation Agreement, Assumption of Risk, and Release of Liability (“Agreement”) is entered into between LIC Judo (“the Gym,” “LIC Judo,” “we,” “us,” or “our”) and the undersigned Student (“Student,” “you,” or “your”).

Student: {name}
Date of birth: {dob}

1. Instructional Program Acknowledgment

I understand that LIC Judo is a martial arts instructional academy that provides judo education, coaching, technical instruction, supervised training, skills development, conditioning programs, seminars, demonstrations, competitions, and related martial arts activities.

I acknowledge that my membership fees are paid for participation in LIC Judo’s instructional programs.

These programs include:

• structured classes; instructor-led instruction; technical development; supervised training; curriculum-based practice; drilling sessions; open mat training sessions; randori; seminars; demonstrations; competitions; and related judo activities.

I understand that LIC Judo is not providing independent recreational access to a facility, equipment rental, or mat rental service.

Any use of LIC Judo’s facility, training areas, equipment, and mats occurs solely as part of participation in LIC Judo’s instructional martial arts programs.

2. Assumption of Risk

I understand that judo is a physically demanding martial art involving physical contact, throws, takedowns, grappling, and controlled resistance training.

I acknowledge that participation in judo involves inherent risks that cannot be eliminated without fundamentally changing the nature of the activity.

These risks include, but are not limited to:

• falls; breakfalls; throws; takedowns; projections; grappling; ground techniques; joint locks; chokes and submission techniques; physical contact with training partners; accidental collisions; improper landings; sprains; strains; fractures; dislocations; bruises; muscle injuries; concussion; head injury; neck injury; spinal injury; equipment failure; and other injuries that may result in serious bodily injury, permanent disability, paralysis, or death.

I understand that injuries may occur even when instructors, coaches, and Students follow appropriate safety practices.

I voluntarily choose to participate in LIC Judo activities and knowingly assume the inherent risks associated with judo training.

3. Open Mat Training Sessions and Practice Opportunities

I understand that LIC Judo may provide open mat sessions, drilling sessions, randori, and other practice opportunities as part of its instructional curriculum.

I acknowledge that these activities are designed to allow students to:

• practice techniques taught through instruction; refine skills; develop timing and movement; improve physical ability; and apply judo techniques in controlled training environments.

I understand that the amount of direct instructor interaction may vary depending on the nature of the session, but these activities remain part of LIC Judo’s overall instructional program.

I voluntarily choose to participate in these activities and understand that the inherent risks of judo apply equally to open mat sessions and related training opportunities.

4. Health Certification and Medical Disclosure

I certify that I am physically able to participate safely in judo training.

I understand that judo involves strenuous physical activity and that I am responsible for determining whether I am medically and physically able to participate on any particular day.

I have had the opportunity to consult with a physician regarding participation if I believe such consultation is appropriate.

I agree to immediately stop participating and notify an instructor if I experience:

• pain; dizziness; illness; injury; unusual symptoms; or any condition that may affect my ability to train safely.

I agree to inform LIC Judo of any medical condition, injury, allergy, limitation, or other circumstance that could affect my participation.

I understand that participating while injured, ill, fatigued, or physically compromised may increase the risk of injury.

5. Release of Liability

To the fullest extent permitted by applicable law, I release and discharge LIC Judo, its owners, officers, directors, employees, instructors, coaches, volunteers, members, landlords, affiliates, successors, and assigns from claims, demands, causes of action, damages, losses, liabilities, costs, or expenses arising out of or relating to my participation in LIC Judo activities.

This release applies only to the fullest extent permitted by law.

I understand that New York law may limit the enforceability of certain liability waivers involving recreational facilities, and nothing in this Agreement is intended to waive rights that cannot legally be waived.

This Agreement does not release or waive claims arising from:

• gross negligence; reckless conduct; intentional misconduct; or any other conduct for which liability cannot legally be released.

6. Indemnification

I agree to indemnify and hold harmless LIC Judo, its owners, instructors, employees, coaches, volunteers, and representatives from claims, damages, losses, liabilities, costs, or expenses arising from my own negligent, reckless, intentional, or wrongful actions while participating in LIC Judo activities, except where prohibited by law.

This indemnification obligation does not apply to claims arising from LIC Judo’s own conduct to the extent prohibited by applicable law.

7. Rules, Safety, and Training Responsibilities

I agree to:

• follow all instructions provided by LIC Judo instructors and staff; comply with safety rules and training protocols; respect training partners; maintain appropriate personal hygiene; wear appropriate judo clothing and protective equipment when required; communicate injuries or discomfort; stop unsafe activities; and report unsafe conditions.

I understand that judo training requires cooperation, discipline, communication, and respect among participants.

I understand that failure to follow safety rules, instructor instructions, hygiene requirements, or conduct standards may result in suspension or termination of membership.

8. Emergency Medical Authorization

If I become injured or require emergency medical care during LIC Judo activities, I authorize LIC Judo and its representatives to seek emergency medical assistance on my behalf if I am unable to do so.

This authorization includes:

• contacting emergency medical services; requesting emergency assistance; providing information reasonably necessary for emergency response; and arranging emergency transportation when appropriate.

I understand that LIC Judo does not provide medical services and has no obligation to diagnose, treat, or provide medical care beyond seeking emergency assistance.

I understand that I am responsible for all medical expenses, insurance claims, deductibles, and treatment costs.

9. Personal Property

I understand that LIC Judo is not responsible for loss, theft, disappearance, or damage of personal property brought onto the premises.

This includes:

• clothing; valuables; electronic devices; training equipment; items stored in changing areas; lockers; and common areas.

I am responsible for securing my own belongings.

10. Photo and Video Consent

LIC Judo may photograph, record video, or capture audio during:

• classes; training sessions; open mat sessions; seminars; demonstrations; competitions; events; and general activities at the facility.

Photographs and recordings may be used for:

• instructional purposes; educational purposes; promotional materials; marketing; advertising; social media; website content; newsletters; member communications; and facility signage.

I understand that content posted on third-party platforms may be copied, shared, reposted, or redistributed beyond LIC Judo’s control.

I understand that I will not receive compensation, royalties, or payment for authorized use of my image, likeness, voice, or appearance.

This media consent is separate from my agreement to participate in LIC Judo’s instructional programs.

11. Minors

If Student is under eighteen (18) years old, this Agreement must also be signed by a parent or legal guardian.

The parent or legal guardian represents that:

• they have authority to sign this Agreement; they have reviewed this Agreement and the Membership Agreement; they understand the risks associated with judo; they consent to participation; and they agree to ensure the minor follows LIC Judo safety and conduct requirements.

12. Severability

If any provision of this Agreement is found invalid, illegal, or unenforceable, that provision shall be modified or interpreted only to the minimum extent necessary, and the remaining provisions shall remain in full force and effect.

13. Governing Law and Venue

This Agreement shall be governed by and interpreted under the laws of the State of New York.

Any legal action relating to this Agreement shall be brought in a court of competent jurisdiction located in Queens County, New York, or another court having jurisdiction under applicable law.

14. Electronic Signature and Entire Agreement

I agree that an electronic signature, digital signature, or electronically submitted acknowledgment has the same legal effect as an original handwritten signature.

This Agreement and the LIC Judo Membership Agreement constitute the entire agreement between LIC Judo and Participant regarding participation in LIC Judo programs.

These documents supersede prior oral or written representations concerning the matters addressed herein.

15. Acknowledgment and Signature

I acknowledge that I have carefully read and understand this Participation Agreement, Assumption of Risk, and Release of Liability.

I understand that:

• judo is a physically demanding martial art; participation involves inherent risks; injuries may occur even when reasonable precautions are taken; I am responsible for making informed decisions regarding participation; and I voluntarily choose to participate in LIC Judo’s instructional programs.

I understand that I am giving up certain legal rights to the fullest extent permitted by applicable law.

I sign this Agreement voluntarily and without coercion, inducement, or reliance on promises outside this Agreement.

Signed by on {sign_date}.