USSD Brown Belt Rank Test

Location:

USSD Oceanside
4170 Oceanside Blvd
#181
Oceanside, CA 92056
(760) 630-8116

Date:

Saturday January  6th, 2024

Time:

9AM

 

$400.00 USD

USSD PHOTO RELEASE FORM
I hereby grant United Studios of Self Defense, Inc permission to use my likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration.
I understand and agree that all photos will become the property of the United Studios of Self Defense (USSD) and will not be returned.
I hereby irrevocably authorize USSD to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo.
I hereby hold harmless, release, and forever discharge USSD from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.
I HAVE READ AND UNDERSTAND THE ABOVE PHOTO RELEASE. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENTS/GUARDIANS AS EVIDENCED BY THEIR SIGNATURES BELOW. I ACCEPT:
PARTICIPANT WAIVER, RELEASE, INDEMNIFICATION, ASSUMPTION OF RISK, AND
LIMITATION OF ALL CLAIMS
NOTICE: THIS IS A LEGALLY BINDING AGREEMENT. Read this document solicit and in
entirety. By signing this agreement, you give up your right to bring a court action to recover
compensation or obtain any other remedy for any personal injury or property damage however
caused arising out of your participation at United Studios of Self Defense.
Programs now or at any time in the future.
ASSUMPTION OF RISK
I hereby acknowledge and agree that participation in Company fitness activities comes with
inherent risks. I have full knowledge and understanding of the inherent risks associated with
participation in Company fitness programs and facilities, including but in no way limited to: (1)
slips, trips, and falls, (2) aquatic injuries, (3) athletic injuries, and (4) illness, including exposure
to and infection with viruses or bacteria. I further acknowledge that the preceding list is not
inclusive of all possible risks associated with fitness program participation and facility use and
that said list in no way limits the operation of this Agreement.
 
 
CORONAVIRUS / COVID-19 WARNING, DISCLAIMER, AND CUSTOMER WARRANT Coronavirus, COVID-19 is an extremely contagious virus that spreads easily through person-to-person contact. Federal and state authorities recommend social distancing as a
means to prevent the spread of the virus. COVID-19 can lead to severe illness, personal injury,
permanent disability, and death. Participating in Company programs or accessing Company
facilities could increase the risk of contracting COVID-19.
Company in no way warrants that COVID-19 infection will not occur through participation in
Company programs of accessing Company facilities.
The undersigned hereby agrees, represents, and warrants that neither the undersigned nor
such participating children shall visit or utilize the facilities, services, and programs of Company
(other than any exclusively online services and programs) within 14 days after (i) returning from
highly impacted areas subject to a CDC Level 3 Travel Health Notice, (ii) exposure to any
person returning from areas subject to a CDC Level 3 Travel Health Notice, or (iii) exposure to
any person who has a suspected or confirmed case of COVID-19. The CDC Travel Health
Network is continuously updating this list and the undersigned agrees that they are aware of this
list and the countries listed.
The undersigned agrees to check the CDC Travel Health Notices list prior to utilizing the facilities, services, and programs of Company, on a daily basis if necessary. The undersigned
hereby agrees, represents, and warrants that neither the undersigned nor such participating
children shall visit or utilize the facilities, services, and programs of Company if he or she (i)
experiences symptoms of COVID-19, including, without limitation, fever, cough or shortness of
breath, or (ii) has a suspected or diagnosed/confirmed case of COVID-19. The undersigned
agrees to notify Company immediately if he or she believes that any of the foregoing access/use
restrictions may apply. The undersigned acknowledges and assumes both the known and
potential dangers of utilizing the facilities, services, and programs of Company and acknowledges that use thereof by the undersigned and/or such participating children may,
despite the Company’s reasonable efforts to mitigate such dangers, result in exposure to
COVID-19, which could result in quarantine requirements, serious illness, disability, and/or
death.
WAIVER, RELEASE, INDEMNIFICATION & COVENANT NOT TO SUE
In consideration of my participation in [insert \ programing description], I, the undersigned
participant, knowingly and voluntarily agrees to release and on behalf of myself, any participating children, my heirs, representatives, executors, administrators, and assigns, HEREBY DO RELEASE Company, its officers, directors, employees, volunteers, agents,
representatives and insurers (“Releasees”) from any causes of action, claims, or demands of
any nature whatsoever including, but in no way limited to, claims of negligence, which I, my
heirs, representatives, executors, administrators and assigns may have, now or in the future,
against Company on account of personal injury, property damage, death or accident of any
kind, arising out of or in any way related to the use of Company facilities/equipment or participation in Company programs whether that participation is supervised or unsupervised,
however the injury or damage occurs, including, but not limited to the negligence of Releasees.
THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY FOR, AND RISK OF
ILLNESS, BODILY INJURY, DEATH OR PROPERTY DAMAGE to the undersigned or such
participating children due to negligence, active or passive, or otherwise while in, about or upon
the premises of Company and/or while using the premises or any facilities or equipment thereon
or participating in any program affiliated with Company The undersigned acknowledges that any
illness or injuries that the undersigned or such participating children contract or sustain may be
compounded by negligent first aid or emergency response of the Releasees and waive any
claim in respect thereof.
In consideration of my participation in Company programing or access to facilities, I, the undersigned participant, agree to INDEMNIFY AND HOLD HARMLESS Releasees from any and all causes of action, claims, demands, losses, or costs of any nature whatsoever arising out
of or in any way related to my program participation or access to facilities.
I hereby certify that I have full knowledge of the nature and extent of the risks inherent in fitness
program participation and facility use and that I am voluntarily assuming said risks. I understand
that I will be solely responsible for any loss or damage, including personal injury, property
damage, or death, I sustain while participating in Company programing or facility use and that
by signing this agreement I HEREBY RELEASE Releasees from all liability for such loss,
damage, or death. I further certify that I am in good health and that I have no conditions or
impairments which would preclude my safe participation in Company programming or facility
use.
I HAVE CAREFULLY READ AND VOLUNTARILY SIGN THIS ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT AND FURTHER
AGREE THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENT APART
FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE. I AM AWARE THAT
BY AGREEING TO THIS AGREEMENT I AM GIVING UP VALUABLE LEGAL RIGHTS, INCLUDING THE RIGHT TO RECOVER DAMAGES FROM COMPANY IN CASE OF ILLNESS,
INJURY, DEATH OR PROPERTY LOSS OR DAMAGE, INCLUDING, FOR THE AVOIDANCE
OF DOUBT AND WITHOUT LIMITATION, EXPOSURE TO COVID-19 AT ANY COMPANY
FACILITY OR PROGRAM AND ANY ILLNESS, INJURY OR DEATH RESULTING THEREFROM. I UNDERSTAND THAT THIS DOCUMENT IS A PROMISE NOT TO SUE AND
A RELEASE OF AND INDEMNIFICATION FOR ALL CLAIMS. IF SIGNING ON BEHALF OF
MINOR: I ALSO UNDERSTAND THAT THIS AGREEMENT IS MADE ON BEHALF OF MY
MINOR CHILD(REN) AND/OR LEGAL WARDS AND I REPRESENT AND WARRANT TO
COMPANY THAT I HAVE FULL AUTHORITY TO SIGN THIS AGREEMENT ON BEHALF OF
SUCH MINOR(S).

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