Schedule

Purple Dragon Martial Arts

Trial Participation Form

By my signature below for myself, and/or as the parent and/or legal guardian of the child or children listed below, I hereby:

(i) agree to assume all risk of injuries, whether minor, serious or catastrophic in nature, that may result from me and/or my child(ren)’s participation in the instructional and/or recreational activities at PURPLE DRAGON MARTIAL ARTS, whether allegedly resulting from my negligence or the alleged negligence of Purple Dragon PURPLE DRAGON MARTIAL ARTS or any of their employees or representatives; and,

(ii) agree, acting for myself, my heirs, personal representatives, and assigns, to release Purple Dragon® and PURPLE DRAGON MARTIAL ARTS, its staff, agents, representatives and instructors from all liability, including claims and suits at law or in equity for any injury, fatal or otherwise, that may result from my or my child’s participation in the instructional and/or recreational activities at Purple Dragon PURPLE DRAGON MARTIAL ARTS, whether allegedly resulting from my negligence or the alleged negligence of Purple Dragon PURPLE DRAGON MARTIAL ARTS or any of their employees or representatives; and,

(iii) represent and warrant by my signature (each parent and/or guardian present must sign below) that I am the legal parent or guardian of the child listed above and that I have read and fully understand each of the above conditions and agree that PURPLE DRAGON® AND PURPLE DRAGON MARTIAL ARTS may act in reliance upon this waiver in allowing me and/or my child to participate.