AIKIDO OF MOUNTAIN VIEW
1924 Plymouth St, Mountain View, CA 94043
Release and Waiver of Liability and Indemnity Agreement for Adults
(revised January 1, 2022)
In consideration of being permitted to participate in AIKIDO OF MOUNTAIN VIEW (“the DOJO”) martial arts programs, and related events and activities, the undersigned adult agrees to the conditions outlined below.
I understand and agree that if at any time I feel anything to be UNSAFE; I will immediately take all precautions to avoid the unsafe area and REFUSE TO PARTICIPATE further.
I fully understand and acknowledge that:
A) There are risks and dangers associated with participation in martial arts events and activities which could result in bodily injury. Such injuries may include, but are not limited to, pulled muscles, dislocated joints, broken bones, transmission of infectious diseases, partial and or total disability, paralysis and death. The social and economic losses and/or damages, which could result from these risks and dangers could be severe.
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B) In accordance with the law, the DOJO does not exclude individuals with medical conditions that do not pose a medically recognized threat to the health or safety of the other students in the normal course of training. I understand that there are some unavoidable circumstances where these conditions may require special caution on my part to minimize danger to others, or to myself, and I acknowledge that it is my responsibility to act accordingly. If I have a disability, chronic illness, or pregnancy, I promise to consult with my physician or therapist before participating in Aikido training.
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C) These risks and dangers may be caused by my action, inaction or negligence or the action, inaction or negligence of others, including, but not limited to, the Releasees named below.
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D) I also understand that there may be risk of exposure to individuals in the DOJO who may have an infectious disease that may be spread by airborne transmission, respiratory droplets or person-to-person contact. These infectious diseases include but are not limited to the common cold, norovirus, flu virus and other respiratory diseases such as COVID 19 (SARS-CoV-2).
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E) I understand that the DOJO may, from time to time, implement special Health and Safety Protocols to reduce the risk of transmission of infectious diseases that may be prevalent in the community, such as COVID-19. Such protocols may include specific requirements for indoor practice related to completing a written waiver and submitting valid proof of vaccination and/or booster vaccination, hand washing, ventilation, class size limitations, mat cleaning, and any other measures the DOJO deems necessary and appropriate for the general health and safety of the community.
I also understand that while Health and Safety Protocols are in effect only those people who fully comply and faithfully observe them will be allowed to enter the DOJO. I also understand the DOJO will publicly post the Health and Safety Protocols and may also publicly post a list of individuals currently compliant and allowed to enter.
I also understand that nobody should enter the DOJO if they have a fever greater than 100.4º or other symptoms including chills, sweats, difficulty breathing, new or worsening cough, whole body aches, vomiting or diarrhea to protect the health and safety of others. And that if I test positive for COVID-19 or have been exposed to a person who tests positive for COVID-19, I will notify the DOJO promptly and self-quarantine for 14 days before re-entering the DOJO.
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F) I understand that I may be training with someone who may be infected with diseases that can be transmitted by exchanges of blood or other bodily fluids. These diseases include but are not limited to HIV/AIDS and hepatitis. I acknowledge that I have read and will follow the DOJO's procedures for dealing with injuries to myself and others that present opportunities for exposure to blood or body fluids. (See Blood Borne Policy below).
Blood Borne Policy
To protect the DOJO family against the risk of disease, the DOJO has adopted the following policy intended to minimize the risk of transmission of HIV / AIDS, Hepatitis-B, and other blood-borne pathogens during training activities. Current available medical evidence suggests that the risk of transmission of HIV during the type of body contact that occurs in Aikido training is extremely slight. Organizations such as the NCAA, the National Academy of Pediatrics Committee on Sports Medicine and the U.S. Olympic Committee have concluded that persons infected with blood-borne pathogens, particularly HIV, should not be barred from participating in contact sports. Certain federal and state anti-discrimination laws may also prohibit such a ban. These organizations have concluded that the already slight risk of transmission of HIV, and of other blood-borne diseases, can be further reduced by adoption of the CDC -recommended "universal precautions" with regard to exposure to body fluids.
The DOJO shall observe these "universal precautions". Generally, this means that the instructors and all persons training in this school shall treat all exposed bodily fluids as if they are infected. Specifically, the following measures will be observed at all times:
1. If you have any open cuts or sores, you must clean them with a suitable antiseptic and cover them securely with a leak proof dressing before coming onto the mat. Make sure they stay covered while you are training. If your hands or feet have broken skin, suitable gloves or split toe Japanese tabi or socks may be worn to cover these areas. If you notice someone else has an open cut or sore, remind her or him of this obligation before training with that person.
2. If a bleeding wound, even a minor one, occurs during training, the person bleeding shall immediately stop training, leave the mat until the bleeding stops and the wound is securely covered. Immediate measures shall be taken to stop the bleeding. If the person needs assistance with this, each person assisting shall wear a pair of non-latex gloves (which are available with the First Aid supplies). Hands are to be washed with soap and hot water immediately after the gloves are removed. All used gloves, bloody rags, paper towels and/or dressings, will be placed in a leak proof plastic bag and disposed of carefully. Blood stains on gi should be treated with a disinfectant solution and handled carefully until it can be laundered or disposed of.
3. If you come into contact with the blood of another, you shall immediately stop training, leave the mat, and wash the exposed area thoroughly with soap and hot water before returning.
4. If blood is present on the mat, the training partner of the person bleeding should insure that no one inadvertently comes in contact with the blood. The blood should be cleaned up as soon as possible by wiping down the exposed surface with a disinfectant solution. It is preferable that the person bleeding cleans up his or her own blood. However, every person assisting in the task shall put on a pair of latex gloves before cleaning, and wash their hands with soap and hot water immediately after the gloves are removed. Bloody rags or paper towels and used gloves shall be disposed of as set out in Paragraph 2.
Finally, I acknowledge that I am responsible for not only my own health and safety, but also the health and safety of others with whom I train. If I know or suspect that I have any illness or disease that might infect others, I will voluntarily refrain from training until I am not a risk to others.
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G) I acknowledge that may be other risks currently not known to us or not reasonably foreseeable at this time.
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H) I release, waive, discharge, and covenant and agree not to sue or make claim against the DOJO or any of its affiliated organizations, their respective agents, officers, directors, instructors including but not necessarily limited to visiting, guest and substitutes, employees, volunteers, sponsors, members, other participants, their parents, guardian(s), supervisors, and if applicable, owners, lessors, and lessees of any premises used by the DOJO or any of its affiliated organizations, all of whom are hereinafter collectively referred to as “Releasee”, from any and all claims, demands, losses, or damages on account of injury, including permanent disability and death or damage to property, caused or alleged to have been caused in whole or in part by the negligence of the Releasee or otherwise.
I) I have read, understand and agree to waive the provisions of California Civil Code section 1542, which reads as follows:
A general release does not extend to claims that the creditor or releasing party does not know or suspect to exist in his or her favor at the time of executing the release and that, if known by him or her, would have materially affected his or her settlement with the debtor or released party.
I hereby agree that this release shall apply to all unknown, unforeseen, unanticipated and latent injuries, damages or losses resulting from the dangers and conditions specified above in this Release, as well as those damages that are now known, foreseen, anticipated and patent, and expressly assumes full responsibility for any injuries, damages or losses that have been or may be incurred as the result of the dangers and conditions specified above in this Release.
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J) I HEREBY acknowledge that participation in MARTIAL ARTS ACTIVITIES ARE VERY DANGEROUS and involve the risk of serious injury and/or death and/or property damage. THE UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES.
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K) I further expressly agree that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the State of California or the state in which the event is conducted, and that if any portion is held invalid, I agree that the balance shall, notwithstanding, continue in full legal force and effect.
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L) I understand that Aikido is an educational system. For the safety of others and myself, I will practice in a considerate and conscientious manner and strictly follow all rules of the DOJO. Should I break any of these rules, I understand that it is the decision of the head instructor whether or not I may continue training. I will abide by this decision.
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M) I further acknowledge that DOJO events may be recorded by video or by other means and I agree to being recorded in whatever format is being used and that the DOJO may use my image in any format for all legal purposes both commercially and non-commercially.
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N) BEING AN ADULT 18 OR MORE YEARS OF AGE, I HAVE READ THIS LIABILITY, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WTHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.
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