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Waivers, Consent, and Statement Forms

FILL OUT AND SUBMIT BOTH WAIVERS

CONSENT AND RELEASE FOR USE OF LIKENESS WAIVER

I (undersigned) acknowledge that upon entry into the premises of 753 Academy LLC (“Academy”), I am being recorded in the non-private areas on the premises for security and safety purposes. These recordings are not shared, posted or uploaded, broadcast or otherwise placed in any media forum except with appropriate law enforcement agencies and only in conjunction with criminal legal proceedings.


I acknowledge that the Academy including any and all of its subsidiaries, licensees, successors, assignees, and any and all other individuals, agencies, corporations, organizations etc. acting on behalf of the Academy (whether by this or any other names and/or designations, and henceforth collectively referred to as the “Released Party”) will inform me prior to obtaining any recording of mine and/or any party related to me in attendance in the case of a related minor (henceforth collectively referred to as “Recorded Party”) when used outside of security purposes as previously identified, the voice, image, photograph, likeness, video, and/or any other form of media as it develops (henceforth collectively referred to as “Likeness”) of the Recorded Party by any medium (including but not limited to video, audio, photo, and/or any media as it develops/evolves or other image, natural or altered in any state by any manner).

 

I acknowledge as the Recorded Party, if I choose to be present during the informed recording session, I hereby grant permission to the Released Party to use the Recorded Party Likeness. Said permission extends into perpetuity. For a valuable consideration, receipt of which is hereby acknowledged, I hereby grant the Released Party all ownership rights and the absolute and irrevocable right and permission to copyright, use and publish the Likeness of the Recorded Party which has been (or is being) obtained pursuant to this Consent and Release. The Likeness may be copyrighted, used and/or published individually or in conjunction with other photography or video works, and in any medium (including without limitation, print publications, public broadcast, CD-ROM format, and/or any media as it develops/evolves) and for any lawful purpose, including without limitation, trade, exhibition, illustration, promotion, publicity, advertising, and electronic publication. Furthermore, I understand that the Likeness of myself may be used in a way that does not accurately reflect my lifestyle or me. Additionally, I understand that my name will only be used in situations where the Likeness is used to reflect my actual circumstances, as understood by the Released Party either at the time of capture or at the time of publication/production.


I waive any right that I, and/or any party related to the Recorded Party, may have to inspect or approve the Released Party's copyright, use or publication of the Likeness, or the advertising copy or printed matter that may be used in connection with the copyright, use and/or publication of the Likeness. Furthermore, I agree and acknowledge that neither I, nor any party related to myself, will receive any form of compensation for the use of my Likeness. I, on behalf of myself and/or any other parties related to myself, release the Released Party (and all persons and/or entities acting under its permission or authority) from any and all claims, including but not limited to claims of libel, slander, invasion of privacy, infringement of copyright or right of publicity, or any other claim related to Use of Likeness (collectively, "Claims"). Furthermore, this release includes without limitation any Claims related to blurring, distortion, alteration, optical illusion, use in composite form, whether intentional or otherwise, or use of a fictitious name, that may occur or be produced in the processing or publication of the Likeness. Additionally, this release includes without limitation any and all other claims of liabilities, damages and expenses associated with authorized use of the above materials.

Additionally, I agree to not obtain and use any recording or transmission of voice, image, photograph, likeness, video, and/or any other form of media, without the expressed written consent of the Released Party and only after a though review by the Release Party and they will maintain and use any material I produce, and I release the Released Party from any copyright or trademark I may possess regarding the media I create on the premises of the Released Party or during any event of the Released Party. The Released Party holds the copyright and trademark of any material presented, shared, transmitted, and created on the premises of the Released Party or of the Released Party.


I agree and acknowledge that the invalidity or unenforceability of any provision of this Agreement, whether standing alone or as applied to a particular occurrence or circumstance, shall not affect the validity or enforceability of any other provision of this Agreement or of any other applications of such provision, as the case may be, and such invalid or unenforceable provision shall be deemed not to be a part of this Agreement. I agree and acknowledge that I am under no pressure or duress to sign this Agreement and that I have been given a reasonable opportunity to review it before signing. I further agree and acknowledge that I am free to have my own legal counsel review this Agreement if I so desire. I understand that my representatives or I cannot revoke this release.


My signature acknowledges that I am over the age of 18 and have read and agree to the terms outlined in this release. I further certify that I am at least 18 years of age. If under 18, my parent/guardian is the below signed If under 18, parent signature.

Assumption of Risk, Waiver and Release of Liability and Indemnity Agreement

This Assumption of Risk, Waiver and Release of Liability and Indemnity Agreement (“the Agreement”), and Consent and Release For Use of Likeness Waiver is entered into by Vitruvian Defensive Solutions LLC (“Vitruvian”), 753 Academy LLC (“753 Academy”) and the undersigned (“I” or “Student”). 

 

I am fully aware of the risks and hazards connected with the participation in martial arts and self-defense training, and instruction in the use of weapons including, edged and blunt weapons, firearms, the discharge of firearms and the firing of live ammunition; that said risks and hazards of participating in such activities include physical injury or even death; and I hereby elect to voluntarily participate in said event(s), knowing that the associated physical activity may be hazardous to me and/or my property. I VOLUNTARILY ASSUME FULL AND SOLE RESPONSIBILITY FOR ANY RISKS OR LOSS, PROPERTY DAMAGE, ILLNESS OR PERSONAL INJURY, INCLUDING DEATH, that may be sustained by me, or loss or damage to property owned by me, as a result of participation in any course, class, session, or workshop (“events”), including any damage, injury or death arising out of the negligence (except gross negligence or intentional acts) of Vitruvian or 753 Academy, whether active or passive, or any of Vitruvian’s or 753 Academy’s trainers, instructors, employees, subsidiaries, affiliates, representatives, successors or assigns, officers, servants, agents, staff, employees, or contractors (hereinafter referred to as RELEASEES) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death or contracting any viral illness or disease , that may be sustained by me, or to any property belonging to me, while participating in physical activity, or while on or upon the premises where the event is being conducted.

 

I further certify that I am at least 18 years of age. If under 18, my parent/guardian is the below signed.   To the best of my knowledge, I am in good physical condition and fully able to participate in this course.

 

By execution of this Agreement, I hereby agree to indemnify and hold harmless Vitruvian from any loss, liability, damage or cost Vitruvian may incur due to the provision of training and/or instruction by Vitruvian to you.

 

It is my expressed intent that this release and hold harmless agreement shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a RELEASE, WAIVE, DISCHARGE, and CONVENTION TO SUE the above named RELEASEES. I hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be construed exclusively in accordance with the laws of the State of Arizona. 

 

In signing this release, I acknowledge and represent that I HAVE READ THE FOREGOING Waiver of Liability and Hold Harmless Agreement, and that I UNDERSTAND IT AND HAVE SIGNED IT VOLUNTARILY as my own free act and deed; no oral representations, statements or inducements, apart from the foregoing written agreements have been made; and I EXECUTE THIS RELEASE FOR FULL, ADEQUATE AND COMPLETE CONSIDERATION FULLY INTENDING TO BE BOUND BY SAME.  I understand and expressly agree that my aforesaid waiver is intended to be as broad and inclusive as permitted by applicable law, and that if any provision of this agreement is held invalid or otherwise unenforceable, the enforceability of the remaining provisions shall not be impaired thereby.

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