(765) 273-3155

©2018 by Trounce Martial Art Fitness.

I, the competitor, do hereby submit my registration for participation in the Nick Pollaro In house tournament September 21st, 2019 held at Trounce Martial Art Fitness at 222 North Madison St. Muncie In. I hereby assume full responsibility and liability for all damages, injuries and losses that I may sustain or incur while participating in or watching the tournament.

I realize that serious injury is commonplace in martial arts tournaments such as the one I am hereby entering and that death is a possibility. I also realize that if I am injured, I might be disfigured, disabled and/or rendered unable to work again. By entering into this competition I agree to and fully accept and assume liability for any and all injuries that I may incur expressly give up and waive any and all claims that I or anyone acting on my behalf or through me might have against Trounce Martial Art Fitness, the owners, promoters, operators, officials, participants, non-participants, Scott Works LLC, or the facility at 222 North Madison St. Muncie, IN for any injury regardless of its nature, effect or affect on me as a result of my participation and/or presence at the tournament.

I
authorize, and agree to hold harmless, whatever medical personnel that may be present at the tournament to take any action necessary, should I become injured.

I further understand that pictures or video may be captured at the tournament. I hereby expressly and irrevocably forever consent to
having my likeness shown, publicized, commented and/or reported on; and I do not expect to, and in fact waive any compensation I might otherwise be entitled to as a result thereof.

I represent that I am in good health; that I am not presently, nor will I participate while under the influence of any drug or medication; that no one affiliated with this tournament has encouraged me to enter or made any representations regarding my fitness or ability to participate; that I have read and understood every provision of this release; and that I am legally competent to and freely enter into this waiver, release and assumption of risk agreement.

In case of minors under 18 years old:

Furthermore, if the competitor is a minor I, Legal Guardian, hereby certify that I am
parent and/or legal guardian of the above named minor who has been given my express permission to compete in the event for which we are registering. And, that I have read and understood every provision of the release of liability and that I am legally competent to and freely enter into this release of liability and assume all risk on behalf of the minor (competitor) named herein and any and all successors, assigns or any other representative acting upon the minor’s behalf.

I've read and have knowledge about the information and I'm aware of the rules and regulations of this tournament.