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Informed Consent / Assumption of Risk:

I am aware that there are significant risks involved in all aspects of physical training. I understand that the reaction of the heart, lungs and vascular system to exercise cannot always be predicted with accuracy. I understand that there is a risk of certain abnormal changes occurring during or following exercise which may include abnormalities of blood pressure or heart rate; chest, arm or leg discomfort; transient light-headedness or fainting; and in rare instances, heart attack, stroke or even death. Excessive physical exertion can result (in rare cases) in rhabdomyolysis. I should look for signs of excessive soreness, darkened urine, and pain in the kidney areas in the days following a particularly intense workout.  While this type of injury is relatively rare, it can occur due to several factors, including (but not limited to) genetic predisposition or dehydration, that may be beyond the control of my trainer. I understand that the programs and classes offered by Kingman Riot MMA are of a nature and kind that are extremely strenuous and can/may push me to the limits of my physical abilities. These risks include, but are not limited to: falls which can result in serious injury or death, injury or death due to negligence on the part of myself, my training partner, or other people around me, injury or death due to improper use or failure of equipment. I am aware that any of these above-mentioned risks may result in serious injury or death to myself and or my partner(s). 

I willingly assume full responsibility for any and all risks that I am exposing myself to as a result of my participation in Kingman Riot MMA programs/classes and accept full responsibility for any injury or death that may result from participation in any activity, class or physical fitness program. I hereby certify that I know of no medical problems that would increase my risk of illness and injury because of my participation in a fitness program designed by Kingman Riot MMA. With my full understanding of the above information, I agree to assume all risk associated with my participation in Kingman Riot MMA programs/classes.

By signing this document, I acknowledge that I have voluntarily chosen to participate in a program of progressive, physical exercise. By signing this document, I acknowledge being informed of the strenuous nature of the program and the potential for unusual, but possible, physiological results including, but not limited to, abnormal blood pressure, rhabdomyolysis, fainting, heart attack, or death. By signing this document, I assume all risks for my health and well-being and hold Kingman Riot MMA, as well as its owners, employees, and other authorized agents including independent contractors, harmless there from. I understand that questions about exercise procedure and recommendations are encouraged and welcome.

Waiver and Release:

I fully understand that my personal exercise program may be strenuous, and I choose to participate voluntarily. I accept all responsibility for my health and any results, injury or mishaps that may affect my well-being or health in any way. I waive any claims, demands, causes or action or any claims or relief whatsoever against, and release Kingman Riot MMA (as well as its owners, employees, and other authorized agents including independent contractors) from any and all liability, claims and/or causes of action that I may have for injuries or other damages, arising out of participation in Kingman Riot MMA activities, including, but not limited to the personal training / nutritional programs and programs/classes.

Photo/Video Release:

I hereby grant Kingman Riot MMA permission to use my photograph/video image in any and all publications for promotion on social media sites, Martial art classes or Fitness classes, including website entries, without payment or any other considerations in perpetuity. I hereby authorize Kingman Riot MMA to edit, alter, copy, exhibit, publish or distribute all photos and images. I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my photo appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph or video images. I hereby hold harmless and release and forever discharge Kingman Riot MMA from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf of my estate which may have by reason of this authorization.

Indemnification:

I recognize that there is risk involved in the types of activities offered by Kingman Riot MMA. Therefore, I accept financial responsibility for any injury that I may cause either myself or to any other participant due to his/her negligence. Should the above-mentioned parties, or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless Kingman Riot MMA, their principles, agents, employees, and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my negligence or intentional act or omission while participating in activities offered by Kingman Riot MMA.

I have fully read and fully understand the foregoing assumption of risk, and release of liability and I understand that by signing it obligates me to indemnify the parties named for any liability for injury or death of any person and damage to property caused by my negligent or intentional act or omission. I understand that by signing this form I am waiving valuable legal rights. I have carefully read this Agreement and fully understand its contents. I am aware that this is a release and waiver of liability and sign it knowingly, voluntarily, and of my own free will.

Payment Terms / Conditions / Agreements:

• Membership fees are paid in advance of services and are non-refundable.
• Membership will be automatically renewed each month unless written notification of cancellation is received 30 days prior to billing date (No exceptions)
• Membership fees are to be paid no later than their monthly billing date and are automatically electronically charged to the authorized payment method listed on this form each month on the billing date.
• There is a $10 late penalty for any payment that is rejected due to insufficient funds, canceled credit cards, expired credit cards and any other reason that may cause an automatic payment to bounce or be rejected. (NO EXEPTIONS)
• Any membership account that is more than 90 days delinquent may be sent to collections without further notice. 

I authorize the purchase of services from Kingman Riot Mixed Martial Arts using this payment authorization form. I agree that I will pay for this purchase and indemnify Kingman Riot Mixed Martial Arts against any liability pursuant to this authorization. I understand that my signature on this form will serve as an authorized signature for each automatic payment.

I give Kingman Riot Mixed Martial Arts authorization to use the payment account listed on this form to automatically pay my membership fees each month. I understand that the monthly membership fee payment will be automatically electronically charged to my credit/debit card account until I ask in writing for my membership to be cancelled 30 days prior to the billing date.

By signing this contract, I certify that I understand and agree to all the payment terms and conditions stipulated by Kingman Riot Mixed Martial Arts.