New York Combat for Stage & Screen Waiver
Participants must fill out the form below prior to participation in NYCSS Classes and Events
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Waiver and Release of Liability
I intend and do hereby agree to be legally bound for myself and for all successors in interest I may have, by this Waiver and Release of Liability, and hereby agree to hold harmless and indemnify New York Combat for Stage & Screen (hereafter referred to as “NYCSS”) and Jared Kirby as well as any coordinators, instructors, officers, members, employees, assistants, volunteers, assigns, or agents of any type whatsoever acting on or in behalf of the aforementioned entities and persons against any claims for damages or other claims for injuries or losses of any kind suffered by me or any others directly or indirectly arising out of any practice, instructions, or other activity related to this class as well as participation in this class or traveling to or from this class.
Appearance Release Form
For good and valuable consideration, receipt of which is hereby acknowledged, I authorize NYCSS, Jared Kirby and their respective parents, affiliates, subsidiaries, licensees, successors and assigns to make use of my appearance. I agree that you may tape and photograph me, and record my voice, conversation and sounds during and in connection with my appearance in class or training session. You shall be the exclusive owner of the results and proceeds of such taping, photography and recording with the right to use in any manner, all or any portion thereof.
I further agree that you may use my name, voice and likeness in any and all media in the promotion, advertising, sale and publicizing in connection with NYCSS, Jared Kirby or affiliated services and release the NYCSS, Jared Kirby and their respective parents, affiliates, subsidiaries, licensees, successors and assigns from all liability, claims and obligations to me in connection with the exercise of the rights granted herein. I hereby waive any right of inspection or approval of my appearance or the uses to which such appearance may be put.
Notice of Agreement
I have understood all that is expressed above in and certify that I am of sound judgment and legally competent to agree to this waiver. Additionally, I certify that I am eighteen years of age or older, or a legally emancipated adult.
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A copy of your responses will be emailed to the address you provided.
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