**LIABILITY WAIVER AND RELEASE FORM**  

 

**1. Assumption of Risk**  

I, the undersigned, hereby acknowledge and fully understand that participation in this private training involves physical activities that may be hazardous. These activities include, but are not limited to, physical contact with other participants, use of training equipment, and participation in exercises and drills. I acknowledge that these activities carry inherent risks, including but not limited to, bodily injury, disability, paralysis, or death. I voluntarily and knowingly assume all risks associated with training, including the risk of serious injury or death.

 

**2. Waiver and Release**  

In consideration of being permitted to participate in private training, I, on behalf of myself, my heirs, executors, administrators, and assigns, hereby waive, release, and discharge Anthony Dill with Dill’s Combat Systems at Algeo MMA, its owners, officers, instructors, employees, agents, and representatives (collectively, “Released Parties”) from any and all claims, demands, damages, liabilities, and causes of action, of any kind and nature, whether known or unknown, arising out of or related to my participation in training, including any injury or harm that may result from negligence on the part of the Released Parties.

 

**3. Medical Declaration**  

I declare that I am in good physical health and do not suffer from any condition that would prevent me from safely participating in training. I understand that it is my responsibility to consult with a physician before participating in any physical activity, including training. I agree to inform the instructors immediately if I experience any pain, discomfort, or other symptoms during training.

 

**4. Emergency Medical Treatment**  

In the event of an emergency, I authorize the Released Parties to obtain necessary medical treatment for me. I agree to assume all costs of medical care and transportation provided in connection with any injury that may occur as a result of my participation in training.

 

**5. Indemnification**  

I agree to indemnify, defend, and hold harmless the Released Parties from and against any and all claims, liabilities, damages, and expenses (including attorney’s fees) arising out of or related to my participation in training, including any claims made by third parties.

 

**6. Photography and Media Release**  

I understand that during training sessions, photographs and/or videos may be taken for promotional, educational, or instructional purposes. I grant the Released Parties the right to use my image, likeness, and/or voice in any media format for these purposes without compensation.

 

**7. Governing Law**  

This Waiver and Release Form shall be governed by and construed in accordance with the laws of the state of Pennsylvania without regard to its conflict of law principles.

 

**8. Severability**  

If any provision of this Waiver and Release Form is found to be invalid or unenforceable by a court of competent jurisdiction, the remaining provisions shall remain in full force and effect.

 

**IF UNDER 18 THIS WAIVER MUST BE COMPLETED BY A PARENT OR GUARDIAN.**

 

**I HAVE READ AND UNDERSTAND THIS LIABILITY WAIVER AND RELEASE FORM. I FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.**