APEX martial arts Waiver

Waiver For? MySelf My Child/Dependent

How did you Hear About Us?
Do you have any Medical Concerns?

No/Yes(Please List) Yes No

(if yes, you must submit a doctor's note specifically stating you are fit to participate in a high intensity fitness workout)
Please list your medical concerns

I confirm that I am the legal guardian and authorize him/her to join APEX martial arts.



1. FreeTrial.  I wish to participate ina free trial of one or more of the programs (each, a « Program ») offered by ArtsMartiaux APEX CV Inc. (« Apex »)and I acknowledge that each participant is required to complete and sign thisAcceptance of Risk, Waiver of Liability and Acknowledgement form in advance of,and as a condition to, participating in any Program. 

2. Activitiesoffered by Apex.  I acknowledgeand understand that Apex is a business operating in the province of Quebecoffering martial art and combat sports courses and training, and variouspersonal training and fitness Programs (collectively referred to as the « Activities »).

3. Acceptanceof Risk.  By signing thisAcceptance of Risk, Waiver of Liability and Acknowledgement, I acknowledge andaccept that the Activities offered or made available by Apex are high risksports and involve by their very nature physical contact that could result in injury.These risks may be due to, without limitation, the intrinsic nature of theActivities themselves which involve intense and frequent physical contact withother participants and with the teaching staff, to the presence or use offitness equipment within the premises, to malfunctioning equipment or equipmentabuse or misuse, to exposed springs, hooks, and/or other pieces of equipment;to slipping and/or falling; to any collision with fixed objects and/or people;to any attempted or poorly executed jumps, runs, stunts, somersaults, maneuversand/or acrobatics; to the physical condition, fitness and/or abilities ofparticipants; and to actions and/or omissions committed by me or the child(each such child, or collectively if there are more than one, referred to asthe «Minor Child») for which I amthe parent, or in respect of whom I hold parental authority or for whom I actas a tutor or legal guardian (in any such capacity, referred to in this Form asthe « Parent »).

I acknowledge and accept asa consequence, freely and in a fully informed manner, the risks and dangersdescribed in the previous paragraph and related to my participation in theActivities, or the participation of the Minor Child in the Activities, asapplicable, and I acknowledge and accept these risks and dangers on my behalf,and if applicable as the Parent on behalf of the Minor Child, in theperformance of the Activities.

4. Supervisionof the Minor Child.  In the eventthe Minor Child uses any equipment or participates in the Activities, Iacknowledge that Apex is in no manner liable for supervising or monitoring theMinor Child and I assume any and all responsibility in this regard in mycapacity as Parent.

5. Stateof Health and Physical Condition. I confirm, after personal verification, that I am, and if applicable theMinor Child is, in good physical condition and that to my knowledge neither Inor, if applicable, the Minor Child has any medical condition or reason thatwould prevent me, or any Minor Child, from participating in the Activities andany Program and that I am, and if applicable the Minor Child is physically,emotionally and mentally able to participate in the Activities and in any Program.

6. Undertakingto Comply with Safety Rules  Ifully understand and will comply with all of Apex’s rules applicable to thesafety of participants. I confirm having explained these rules to the MinorChild et to have ensured that the Minor Child understands these rules.  I confirm that I will be solely responsiblefor my personal safety and that of any Minor Child.

7. Releaseand Waiver of Liability.  In connection with the preceding, and to theextent permitted by law in the province of Quebec, I hereby release, acting formyself and on behalf of any Minor Child, Apex, its teaching and supervisingpersonnel and other employees, its directors, officers, and/or otherrepresentatives (collectively referred to as the « Apex Beneficiaries ») from any and all liability for anyDamages (defined below) resulting from my participation, and if applicable thatof any Minor Child, in the Activities, subject to the gross fault orintentional fault of any Apex Beneficiary, and I expressly waive any right ofaction that I may have (or that the Minor Child may have) against any ApexBeneficiary in respect of any damages, claims, losses, injury, costs orexpenses (collectively referred to as « Damages ») that I may suffer or incur, or if applicable thatthe Minor Child may suffer or incur, by reason of my participation or that ofthe Minor Child in the Activities, excluding however any right of actionagainst an Apex Beneficiary for Damages resulting directly from the gross faultor intentional fault of such Apex Beneficiary.


8. Scope and Applicable Law. I acknowledge and agree that this Acceptance of Risk, Waiver ofLiability and Acknowledgement form is intended to be as broad as possible tothe extent permitted by the laws of the province of Quebec and the applicablelaws of Canada, and that this form is governed by, and shall be interpreted inaccordance with, such laws.


SIGNED this__________day of______________________,2019.


Signature Here Please

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