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NINE LIMBS STRIKERS LLC

DBA NINE LIMBS STRIKERS

ENROLLMENT WAIVER FORM

MARTIAL ARTS TRAINING AND FITNESS TRAINING ARE INHERENTLY DANGEROUS AND PHYSICALLY DEMANDING. IF YOU HAVE EXISTING MEDICAL CONDITIONS, BACK PROBLEMS, A HEART CONDITION, OR ARE PREGNANT, YOU COULD BE AT GREAT RISK. PLEASE CONSULT YOUR PHYSICIAN BEFORE PARTICIPATING IN ANY ACTIVITY.

Safety is the highest priority for everyone at NINE LIMBS STRIKERS, LLC, North Carolina limited liability company (“NINE LIMBS STRIKERS”) Nine Limbs Strikers has a zero-tolerance policy for the consumption of alcohol on its premises. Swearing or generally rude behavior toward the staff or other participants will not be tolerated.

Failure to comply with any staff request will result in the suspension or termination of your privileges; it is for your safety that staff instructions and decisions are final. Repeat offenses may result in a permanent ban from the Nine Limbs Strikers premises.

In consideration of allowing me to participate in any way in the activities of Nine Limbs Strikers at its studio (the “Property”), and on behalf of myself, my personal representatives, heirs, next of kin, successors and assigns:

1. I acknowledge, agree and represent that I have inspected the Property and deem such Property as being safe and reasonably suited for my intended purpose. If at any moment I feel anything inside the Property to be unsafe, I will immediately advise Nine Limbs Strikers personnel of such and will immediately leave the Property.

2. I hereby assume all responsibility and liability for all acts or activities of myself for any and all actual, alleged to threatened bodily injury, death, or property damage that may be caused by me or by my properties, or possessions, including, but not limited to, actions in any way arising out of or resulting from participation in martial arts or physical fitness activities (including without limitation therapeutic massage, stretching or similar calisthenics) and including actual, alleged or threatened inhalation of, ingestion of, contact with, exposure to, existence of, or presence of, any “fungi” or bacteria on or within a building or structure, including its contents, regardless of whether any other cause, event, material or product contributed concurrently or in any sequence to such injury or damage.

3. I hereby release, waive, discharge and covenant not to sue Nine Limbs Strikers, LLC, Nine Limbs Strikers limited liability company (“Nine Limbs Strikers”) and its officers, agents, members, or employees, its landlord, and their successors or assigns (all hereinafter referred to as the “Indemnified Parties”) for, from and against any and all liability to me, my personal representatives, heirs, next of kin, successors and assigns, or any third party for all harm, loss, liability, damages or costs (including, without limitation, attorneys’ fees and costs) for bodily injury, death, or property damage that may be caused by me or by my properties, or possessions, including, but not limited to, actual, alleged or threatened actions in any way arising out of or resulting from participation in martial arts activities or physical fitness activities (including without limitation therapeutic massage, stretching or similar calisthenics), whether any such claim may be based upon alleged active or passive negligence, whether caused by me, one of the Indemnified Parties, another customer, or otherwise, or upon any alleged breach of any statutory duty or obligation.

4. I hereby agree to indemnify and hold harmless any of the Indemnified Parties for, from and against any and all harm, loss, liability, damages or costs (including, without limitation, attorneys’ fees and costs) they may incur due to any and all actual, alleged or threatened lawsuits, claims, regulatory proceedings, investigations, arbitrations or other proceedings brought against the Indemnified Parties arising out of my injury or death or damage to property that may incur while I am in the Property or any claims brought by third parties and whether caused by me, the Indemnified Parties, another customer or otherwise.

5. I hereby acknowledge and agree that the activities taking place in the Property are dangerous and involve the risk of serious injury and/or death and/or paralysis and/or property damage, and that the activities may become more hazardous or dangerous during the time I am at the Property. I am aware of all the risks and hazards inherent with participating in activities at Nine Limbs Strikers. I also expressly acknowledge and agree that injuries received may be compounded or increased by negligent rescue operations or procedures of the Indemnified Parties. This Waiver shall extend to all negligent acts by the Indemnified Parties, including, without limitation, negligent rescue operations, and is intended to be as broad and inclusive as is permitted by the laws of the State of North Carolina and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full force and effect.

6. I agree to allow Nine Limbs Strikers to utilize my name and/or image and/or likeness in connection with any promotional or other activities, including, without limitation, in any and all media such as television, film, video, print and electronic form.

7. Nine Limbs Strikers does not provide medical or liability insurance, all applicants must have their own valid medical insurance coverage. Nine Limbs Strikers reserves the right to revoke all rights and privileges pertaining to participant’s involvement in, or related to, its activities.

8. THE MAXIMUM AMOUNT OF LIABILITY TO BE CHARGED TO NINE LIMBS STRIKERS SHALL BE THE AMOUNT OF FEES PAID BY ME TO NINE LIMBS STRIKERS FOR THE GOODS AND SERVICES PROVIDED BY NINE LIMBS STRIKERS ,REGARDLESS OF THE NATURE OF THE CLAIMS MADE BY ME, MY HEIRS OR REPRESENTATIVES, WHETHER STATED IN TORT OR IN CONTRACT, AND WHETHER NINE LIMBS STRIKERS HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LIABILITY. IN NO EVENT SHALL NINE LIMBS STRIKERS BE LIABLE FOR DIRECT, INDIRECT, COMPENSATORY, CONSEQUENTIAL, PUNITIVE OR EXEMPLARY DAMAGES.

9. In signing this Enrollment Waiver Form, I acknowledge and represent:

a. I am at least 18 years of age or I will have my parent or legal guardian sign this form;

b. I have read the foregoing, understand it, and sign voluntarily;

c. I am not pregnant;

d. I do not suffer from high blood pressure, a heart condition, back problems, or any

other medical condition that may be aggravated by participating in martial arts

activities or physical fitness;

e. I will refrain from engaging in negligent, reckless, willful or wanton conduct during

my participation at Nine Limbs Strikers Property.

f. I have read, understand, and will obey all rules and regulations of Nine Limbs

Strikers;

g. I will closely observe and follow the instructions of all posted signs and Nine Limbs

Strikers personnel; and

h. This Enrollment Waiver Form is continuing and shall remain in effect for this and

future visits to Nine Limbs Strikers.

VISITOR WAIVER

By voluntarily affixing my signature below, I warrant that I have read and understand all of the foregoing, that I have given up substantial rights by signing it, and have signed it freely and voluntarily without any inducement, assurance, guarantee, or other oral representation being made to me, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.

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