ACKNOWLEDGEMENT AND RELEASE FORM

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I, THE APPLICANT, ON BEHALF OF MYSELF, MEMBERS OF MY FAMILY, MY HEIRS, EXECUTORS, ADMINISTRATORS AND ASSIGNS, HEREBY FOREVER RELEASE, DISCHARGE AND HOLD HARMLESS GUY MEZGERʼS COMBAT SPORTS CLUB/FS MARTIAL ARTS INC, REPRESENTATIVES AND AGENTS FOR ANY INJURY, LOSS OR DAMAGE TO MY PERSON OR PROPERTY HOWEVER CAUSED, ARISING OUT OF OR IN CONNECTION WITH MY TAKING PART IN MARTIAL ARTS CLASSES, SELF DEFENSE SEMINARS AND ACTIVITIES AND NOTWITHSTANDING THAT THE SAME MAY HAVE BEEN CONTRIBUTED TO OR OCCASIONED BY THE NEGLIGENCE OF GUY MEZGERʼS COMBAT SPORTS CLUB/FS MARTIAL ARTS INC, REPRESENTATIVES OR AGENTS. PLEASE NOTE: PARTICIPANTS MUST SUPPLY THEIR OWN PROTECTIVE EQUIPMENT. THE UNDERSIGNED ACKNOWLEDGES THAT: 1.HE/SHE IS DESIROUS OF USING, AS A MEMBER ON A MEMBERSHIP BASIS, THE MARTIAL ARTS STUDIO REFERRED TO AS GUY MEZGERʼS COMBAT SPORTS CLUB/FS MARTIAL ARTS INC, 2.HE/SHE HAS RECEIVED A COMPLETELY EXECUTED COPY OF THIS AGREEMENT 3.HE/SHE CONFIRMS THAT THERE WERE NO VERBAL PRESENTATIONS OTHER THAN THOSE SPECIFIED IN THIS AGREEMENT. 4.HE/SHE MAY BE PHOTOGRAPHED OR FILMED WHILE ATTENDING AT THE PREMISES OF GUY MEZGERʼS COMBAT SPORTS CLUB/FS MARTIAL ARTS INC, AND HE/SHE GIVES PERMISSION TO GUY MEZGERʼS COMBAT SPORTS CLUB/FS MARTIAL ARTS INC, AND ALL THEIR AFFILIATES TO USE ANY AND ALL PHOTOS, VIDEO FOOTAGE, AND/OR VIDEO STREAMING FOR PROMOTIONAL, SALES, PUBLICITY, AND ADVERTISING PURPOSES FOR ALL MEDIA INCLUDING INTERNET. 5.THE WAIVER WAS READ AND HE/SHE AGREES TO ABIDE BY IT.
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