Please read and acknowledge
I agree to assume full risk and to waive, relinquish and release all claims I and or the participant may
have against, indemnify, hold harmless and defend the Newbury Park Martial Arts Center. This release
includes as well NPMAC officers, agents, servants and employees from any such claims resulting from
injury, damages or loss sustained on account of participation in NPMAC programs. On behalf of the
participant, I acknowledge the existence of risks in connection with program activities, assume such risks
and agree to accept the responsibility for any injuries sustained by the participant. I understand that every
precaution is taken to protect the safety of each participant and agree to emergency treatment by a
physician or hospital in the event that I or the emergency contact listed cannot be reached.
I give my consent for my child to receive medical or surgical aid as may be deemed necessary and
expedient by a duly licensed or recognized physician or surgeon in the case of an emergency when a
parent or guardian cannot be reached. Consent is also given for an NPMAC employee or his/her duly
appointed representative to transport my child for emergency medical treatment in said situation.
I release the NPMAC from all claims my child might sustain as a result of participation in this program.