RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT

BY SIGNING THIS DOCUMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE

PLEASE READ CAREFULLY - Initial Here:

To: Rothwell Davies Martial Arts (dba: Pacific Top Team Vernon Brazilian Jiu-Jitsu or PTT Vernon) (the “Owner”)

Member Information (Required):
First Name: {first_name}
Full Name: {name}
Date of Birth: {dob}
Address: {address}
Phone: {phone}

Emergency Contact Name: {contact_name}
Emergency Contact Phone: {contact_phone}
Emergency Contact Relationship: {contact_relation}

DEFINITION

In this Agreement the term “Activities” shall include all activities in any way directly or indirectly related to participation in the martial arts and other related activities offered by the Owner including, but not limited to, activities with other students, staff, or instructors which may include: extreme physical exertion; sparring; physical combat; throwing; wrestling; chokeholds; presser locks; and punching or kicking; and other activities which the staff or instructors may deem suitable for physical training; all of which may result in injuries including but not limited to: soreness; bruising; strained muscles or tendons; sprained ligaments; joint dislocations; unconsciousness; broken bones; paralysis; brain damage and death.

In this Agreement the term “Ward” shall include minor children, or persons under guardianship due to age or incapacity.

ASSUMPTION OF RISKS

I am aware that the Activities involve many risks, danger and hazards, inherent or otherwise, including but not limited to the inherently dangerous nature of physical combat, the failure to use or properly use safety equipment, and the actions of other students. I understand that due to the location in which the Activities occur, medical treatment may not be readily available in the event of an injury or accident. I am also aware that there is a risk of NEGLIGENCE ON THE PART OF THE OWNER OR THE OWNER’S STAFF OR AGENTS, INCLUDING THE FAILURE ON THE PART OF THE OWNER AND ITS STAFF OR AGENTS TO SAFEGUARD OR PROTECT ME OR MY WARD FROM THE RISKS, DANGERS AND HAZARDS ASSOCIATED WITH THE ACTIVITIES.

I FREELY ACCEPT AND FULLY ASSUME ALL RISKS, DANGERS AND HAZARDS ASSOCIATED WITH THE ACTIVITIES AND THE POSSIBILITY OF MY LOSS OF PROPERTY, PERSONAL INJURY, DEATH OR THAT OF MY WARD AND LOSS RESULTING THEREFROM.

Initial Here:

RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT

In consideration of the Owner agreeing to allow me, or my Ward’s, participation in the Activities, and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, I hereby agree as follows:

TO WAIVE AND ALL CLAIMS that I have or may have in the future against the Owner and its partners, directors, officers, employees, agents, guides, contractors, sub-contractors, and other representatives (all of whom are hereinafter collectively referred to as “the Releasees”) and to RELEASE THE RELEASEES from any and all liability for any loss of property, other losses, damage, injury or expense that I, or my Ward may suffer, or that my next of kin may suffer as a result of or arising out of my participation in the Activities, DUE TO ANY CAUSE WHATSOEVER, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, BREACH OF WARRANTY, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE ON THE PART OF THE RELEASEES, AND FURTHER INCLUDING THE FAILURE ON THE PART OF THE RELEASEES TO SAFEGUARD OR PROTECT ME OR MY WARD FROM THE RISKS, DANGERS AND HAZARDS OF THE ACTIVITIES REFERRED TO ABOVE;

Initial Here:

TO REIMBURSE THE RELEASEES AND ACCEPT RESPONSIBILITY FOR THE RELEASEES for any loss of property, other loss, damage, expense or liability to any third party, including my Ward, resulting from my or my Ward’s participation in the Activities;

That this Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns and representatives, in the event of my death or incapacity;

That this Agreement shall be governed by and interpreted in accordance with the laws of the Province of British Columbia;

That any litigation involving the parties to this Agreement shall be brought within the Province of British Columbia.

I CONFIRM THAT I HAVE READ AND UNDERSTOOD THIS AGREEMENT PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNS MAY HAVE AGAINST THE RELEASEES.

Signature of Member or Guardian:
Date Signed: {sign_date}

Membership Agreement & Payment Authorization

Pacific Top Team Vernon Martial Arts

Member Information

• Full Name: {name}

• Date of Birth: {dob}

• Address: {address}

• Phone Number: {phone}

• Emergency Contact Name: {contact_name}

• Emergency Contact Phone: {contact_phone}

• Emergency Contact Relation: {contact_relation}

Membership Details

• Membership Title: {membership_title}

• Membership Start Date: {start_date}

• Membership Duration: {membership_duration}

• Membership Recurrence: {membership_recurrence}

• Monthly Fees: {membership_fees}

• Signup Fee: {signup_fee}

• Membership Expiration (if applicable): {expiration_date}

• Total Membership Cost: {membership_total_amount}

1. Membership Cancellation

• Membership cancellations must be submitted in writing by email to pttvernon@gmail.com no later than two (2) weeks prior to the next scheduled withdrawal.

• Cancellations that do not follow this process will continue to be billed.

• Payments already processed prior to receipt of a cancellation request are non-refundable.
  Cancellations take effect only after proper notice is received.

• Members are responsible for notifying Pacific Top Team Vernon when they wish to cancel, pause training, or take a leave of absence.

• DUES CANNOT BE REFUNDED RETROACTIVELY IF NOTICE IS NOT PROVIDED.

2. Payment System (EFT & Credit Card)

• Monthly dues are processed on the 1st of each month by:

  • Electronic Funds Transfer (EFT), or

  • Recurring credit card charge.

• By providing banking or credit card information, you authorize Pacific Top Team Vernon to process recurring payments.

• Members must ensure:

  • Bank accounts have sufficient funds

  • Credit cards remain valid and up to date

• Any failed, declined, or returned payments remain the responsibility of the member.

• A $25 NSF (Non-Sufficient Funds) fee will be charged for any bounced or returned payment.

3. EFT Setup Requirements

Provide one of the following:

A. Void Cheque

Write the following on the back:

• Account type: Chequing or Savings

• Student’s Name

• Training Program

• Monthly Withdrawal Amount

B. Direct Banking Information

• Account Type: Chequing or Savings

• Bank #

• Transit #

• Account #

4. Member Responsibility

By enrolling, the member acknowledges responsibility for:

• Maintaining accurate payment information

• Providing the required two-week cancellation notice

• Ensuring funds or valid credit card status

Payments processed before proper cancellation notice remain valid charges and are not eligible for refund.

5. Acknowledgement & Signature

By signing below, I acknowledge that I have read, understood, and agree to all terms of this Membership Agreement.

• Name of Member or Guardian:

• Date Signed: {sign_date}

• Initials:

• Optional: (e.g., consent to policies or communication)

Signature: