Membership

Sign the waiver.

This is the same waiver, release of liability, assumption of risk and indemnity agreement used in person at the academy. Read it in full before signing — it's a legally binding document.

Read the full waiver (PDF) →

Please read carefully before signing. By signing this form, you give up certain legal rights, including the right to sue Private Kombat and its coaches for injury, loss, damage or death arising out of your participation — including injury caused by the negligence of Private Kombat, its owners, coaches, employees, contractors or other participants. If you have questions, ask a member of staff before signing, or seek independent legal advice.

Section 1Participant information

Full legal name

Date of birth

Phone

Address

City / Province / Postal code

Section 2Emergency contact

Name

Relationship

Phone

Alt. phone

Section 4Acknowledgement and assumption of risk

Combat sports and physical training are inherently dangerous activities that carry a significant risk of serious personal injury, permanent disability and death — including but not limited to fractures, concussion and other brain injury, spinal injury, and injury caused by the conduct or negligence of coaches, staff or other participants. Risk cannot be eliminated no matter how carefully the activities are supervised. I freely and voluntarily accept and assume all such risks, known and unknown, and accept full responsibility for any injury, loss or damage I may suffer. Full text, Section 4 →

I have read and understood Section 4 and I assume these risks.

Initials

Section 5Medical fitness

I confirm I am in good physical health and not aware of any condition that would make participation unsafe. I agree to disclose any injury, illness, concussion, pregnancy, medication or condition that arises, and to stop training and seek medical attention when required. I consent to Private Kombat arranging emergency treatment on my behalf if I am injured and unable to consent, and accept responsibility for its cost.

Medical conditions, allergies, past injuries or medications (write "None" if none apply)

Section 6Waiver and release of liability

In consideration of Private Kombat permitting me to participate, I agree to waive all claims against Private Kombat, its owners, coaches, employees, contractors and other participants, to release them from all liability for any loss, damage, expense or injury, including death, due to any cause whatsoever, including negligence, and to hold them harmless and indemnify them against any claim arising from my participation. Full text, Section 6 →

I have read and understood Section 6 and I am giving up the right to sue.

Initials

Section 8Photography & media release (optional)

Private Kombat may photograph or record classes for promotional and instructional purposes. Participation does not depend on this choice.

I consent to Private Kombat using my name, image, voice and likeness in photographs, video and social media content without compensation. I do not consent to my image or likeness being used in Private Kombat promotional content.

Section 12Parent / legal guardian consent — under 18

Based on the date of birth entered above, this participant is a minor. A parent or legal guardian must complete this section and sign below on the participant's behalf.

Name of minor participant

Parent / guardian name

Relationship to minor

Parent / guardian phone

Parent / guardian email

As parent/guardian, I confirm I have read and understood the entire agreement including Sections 4 and 6, I consent to the minor's participation and assume all risks on their behalf and my own, I waive and release my own claims, and I agree to indemnify Private Kombat against any claim brought by or on behalf of the minor. Full text, Section 12 →

Section 11 / 12Signature

Signature of participant

Draw with mouse, trackpad or finger.

Signature of parent / legal guardian

Draw with mouse, trackpad or finger.