Dual Release of Liability Waiver

I, despite all reasonable precautions implemented for safety, am fully aware of and appreciate the risks, including the risk of catastrophic injury, paralysis and even death, as well as other damages and losses associated with participation in the programs or activities. I knowingly and willingly assume all such risks. Consequently, I hereby for myself, heirs, executors and administrators, do waive and release any and all rights and claims for damages against the owners, operators, coaches and other members of USA Ninja Milford, LLC and USA Ninja Challenge from personal injury or accident of any sort or nature suffered by me, the undersigned, by reason of participation or membership in classes, lessons or any programs or activities of USA Ninja Milford, LLC and USA Ninja Challenge.

In, addition, I, the below named minor's parent and/or legal guardian, understand the nature of these activities and the minor's experience and capabilities and believe the minor to be qualified, in good health, and in proper physical condition to participate in such activity. I hereby release, discharge, covenant not to sue, and agree to indemnify and save and hold harmless each of the releasee's from all liability claims, demands, losses, or damages on the minor's account, including negligent rescue operations. I further agree that if, despite this release, I, the minor, or anyone on the minor's behalf makes a claim against any of the releasees named below, I will indemnify, save, and hold harmless each of the releasees from any litigation expenses, attorney fees, loss liability, damage, or cost any may incur as the result of any such claim.

Signee (Parent) Information

First Name *

Last Name *

Phone *

Email Address *

Address *

Address Line 2

City *

State *

Zip *

Permission to Use Photograph*

Yes, my child may be photographed

No, my child may not be photographed

Subject: Competitions, workouts, team activities and functions at any USA Ninja Challenge facility or the location of any USANC competition or activity. I grant to USA Ninja Milford, LLC and USA Ninja Challenge, its representatives and employees the right to take photographs of my child in connection with the above-identified subject. I authorize USA Ninja Challenge, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that USA Ninja Challenge may use such photographs of my child with or without his/her name for any lawful purpose, including publicity, illustration, advertising, and web content. I have read and understand the above.

Emergency Contact Name*

Emergency Contact Phone*

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By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.