Training & Media Release Waiver

As a member/participant of ETX Wrecking Crew Martial Arts LLC. of Longview, TX,I/my child, intend(s) to and will engage in strenuous physical activities and instruction on the premises. I understand that these activities involve certain risk and exposure to personal injury, to which I assume responsibility for myself and/ or my child or any other family member who may participate. In consideration, I hereby release in full and forever ETX Wrecking CrewMartial Arts LLC. owners, directors, shareholders, agents, trainers, and any employee, whether acting officially or otherwise on behalf of myself or family member or representative heirs, executors, administration and personal representative from any gross negligence, sickness, claims, demands, or cause of action relating to or deriving from any injury to myself or family member including children during, or arising from training or use of ETX Wrecking Crew Martial ArtsLLC. of Longview, TX.


I also grant ETX Wrecking Crew Martial Arts LLC. employees and representatives the right to take photograph of myself, child, or any accompanying individual, and property while at ETX Wrecking Crew Martial Arts and to use, and publish these photos or videos in print and/or electronically. I agree that ETX Wrecking CrewMartial Arts may use such media with or without my name, and for any lawful purpose, including for example such purpose as publicity, illustration, advertisement, and web content. I understand and agree that ETX Wrecking CrewMartial Arts LLC. reserves the right to terminate any membership and refuse service to anyone at any given time with or without consent of members.


Academy Rules & Etiquette


I have read and consent to all terms and rules in order to participate in training at East Texas Wrecking Crew. By signing below, I acknowledge my understanding of the waiver, release, and etiquette requirements. 

Name
Email
Phone
Guardian Name (if applicable)
Date of Birth(Required)
Phone Number(Required)
Interested Class Type (Adults, Kids, Tiny Grapplers, Women's Self Defense, Kickboxing, LEO or Adopt a Cop)(Required)
Please Indicate if You Are a First Responder, Military, or None of the Above(Required)
Are you approved by Adopt a Cop?(Required)
Emergency Contact First & Last Name(Required)
Emergency Contact Phone Number(Required)
Emergency Contact Relationship to Trainee (Parent, Spouse or Legal Guardian)(Required)
Are You Signing up More Than 1 Member? (Please name all members you wish to sign up. Do not submit this waiver multiple times.)(Required)
Date
Signature