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Effective immediately upon execution, I, {name}, for and in participation of activities provided by Rochester Phoenix Martial Arts, LLC, the receipt and sufficiency of which is hereby acknowledged, do hereby release and forever discharge Rochester Phoenix Martial Arts, their agents, employees, successors and assigns, and their respective heirs, personal representatives, affiliates, successors and assigns, and any and all persons, firms or corporations liable or who might be claimed to be liable, whether or not herein named, none of whom admit any liability to the undersigned, but all expressly denying liability, from any and all claims, demands, damages, actions, causes of action or suits of any kind or nature whatsoever, which I now have or may hereafter have, arising out of or in any way relating to any and all injuries and damages of any and every kind, to both person (physical and/or psychological) and property, and also any and all injuries and damages that may develop in the future, as a result of or in any way relating to the following: 

• Any activity within 563 Titus Ave, Rochester, NY 
• Any physical activity while under instruction or independent 
• All martial arts-related activity, with or without equipment 
• All seminars, events, tournaments, camps, classes, private lessons, birthday parties, etc. 

Potential injuries arising from martial arts may include but are not limited to: 

*Brain damage 

*Broken bones 

*Strains, sprains, bruising 

*Disfigurement 

*Cuts and scratches 

*Skin infections 

It is understood and agreed that payment of dues is made and received in full settlement and satisfaction of the causes of action, claims, and demands mentioned herein; that this Release contains the entire agreement between the parties; and that the terms of this agreement are contractual and not merely a recital. This Release may not be altered, amended, or modified except by a written document signed by both parties. 

Furthermore, this Release shall be binding upon the undersigned and his respective heirs, executors, administrators, personal representatives, successors, and assigns. This Release shall be subject to and governed by the laws of the State of New York. 

This Release has been carefully read and fully understood by the undersigned. The terms have been explained to me, and I am freely, knowingly, and voluntarily entering into this Release. 

I hereby permit images or video of me or my child captured during any class, event, or activity by Rochester Phoenix Martial Arts for the sole purposes of promotional material and publications, including website, fundraising, or any other like purpose, and further give my consent for said images to be used for website and social media. And that any such photos and videos will remain the property of Rochester Phoenix Martial Arts. I hereby grant Rochester Phoenix Martial Arts permission to use mine or my child's likeness in a photograph in all publications for all purposes, including website entries, without payment or any other consideration in perpetuity. I authorize Rochester Phoenix Martial Arts to edit, alter, copy, exhibit, publish, or distribute this photo to publicize Rochester Phoenix Martial Arts programs or any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph. 

We respect your choice not to be photographed. 

Please let us know if you want to avoid being photographed or having your child photographed. 

We will never publish a photo of you or your child if you do not want us to do so.

Name of member: {name}

Parent or Guardian name:

 A 30-DAY WRITTEN NOTICE IS REQUIRED FOR ALL MEMBERSHIPS.

Adult Memberships

1.  Your membership is considered active until you cancel, regardless of attendance.
2. Payments will continue and be ongoing until we receive a written cancellation. 
3.  Refunds will only be issued if a 30-day cancellation is given regardless of attendance. 

Kids Memberships

1.  If your child wants to cancel, talk to us. 
2. A cancellation form must be filled out 30 days before canceling membership.
3. Kids memberships are considered active until they are canceled, regardless of attendance. 

• Payments will continue and be ongoing until we receive a written cancellation. 

1.  Refunds will only be issued if a 30-day cancellation is given, regardless of attendance. 

Communication is key. Please talk to us with any concerns or questions.

Name of member: {name}

Parent or Guardian name: