of being permitted to participate in any way, including travel and
from, in any Judo tournament, practice, clinic, and related events
and activities of United States Judo, Inc., United States Judo Federation,
United States Judo Association, Department of Defense, Department
of Navy, Great Lakes Naval training Center, U.S. Military Entrance
Processing Command, Navy Recruit Training Command, Gurnee Park and
Recreation district, and Gurnee Judo Club, I hereby:
1. Acknowledge that I am familiar with the sport of Judo and understand
the rules governing the sport of Judo.
2. Agree that prior to participating, I will inspect the mats, equipment,
facilities, competition pools or divisions and the elimination or
scoring system to be used, and if I believe anything is unsafe or
beyond my capability, I will immediately advise my coach, supervisor,
and/or tournament official of such conditions and refuse to participate.
3. Acknowledge and fully understand that I will be engaging in a
contact sport that might result in serious injury, including permanent
disability or death, and severe social and economic losses due to
not only my own actions, inactions, or negligence, but also to the
actions, inactions, or negligence of others, the rules of the sport
of Judo, or conditions of the premises or of any equipment used.
Further, I acknowledge that there may be other risks not known to
me or not reasonably foreseeable at this time.
4. Knowing the risks involved in the sport of Judo, I assume all
such risks and accept personal responsibility for the damages following
such injury, permanent disability, or death.
5. Release, waive, discharge and convenant not to sue the of United
States Judo, Inc., United States Judo Federation, United States
Judo Association, Department of Defense, Department of Navy, Great
Lakes Naval training Center, U.S. Military Entrance Processing Command,
Navy Recruit Training Command, Gurnee Park and Recreation district,
and/or Gurnee Judo Club, together with their affiliated clubs, their
respective administrators, directors, agents, coaches, and other
employees o volunteers of the organization, event officials, medical
personnel, other participants, their parents, guardians, supervisors
and coaches, sponsoring agencies, sponsors, advertisers, and if
applicable, owners, lessors, and lessees of premises used to conduct
the event, all of whom are hereinafter referred to as releasee,
from any and all claims, demands, losses, or damages on account
of injury, including permanent disability and death and damage to
property, caused or alleged to be cause in whole or in part by the
negligence of the releasee or otherwise to the fullest extent permitted
I HAVE READ THE ABOVE WARNING, WAIVER, AND RELEASE, UNDERSTAND THAT
I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND KNOWING THIS, SIGN
IT VOLUNTARILY. I AGREE TO PARTICIPATE KNOWING THE RISK AND CONDITIONS
INVOLVED AND DO SO ENTIRELY OR MY OWN FREE WILL. I AFFIRM THAT I
AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE,
I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENT/GUARDIAN AS EVIDENCED
BY THEIR SIGNATURE BELOW.
Participant (please print name) Participants Signature Date