Application to Train in New South Wales at PTJ Muaythai Gym.
I, , hereby express my desire to be trained as a Muay Thai Fighter (hereinafter ‘Fighter’) by a Trainer registered with Muaythai Australia (hereinafter referred to as the “Federation”).
1) I hereby absolutely release the Federation, my Trainer/s and his/her employees, agents and representatives from:
a) Any claim whatsoever I, or my executors, may otherwise have had arising out of training with my Trainer/s, their employees, agents or representative or at any time thereafter by reason of my suffering of any disease, deterioration of health, illness, aggravation of any condition of ill health or sustaining any injury whatsoever as a result of training as a Fighter either directly or indirectly or the use of the facilities or equipment afforded to me by my Trainer/s; and
b) Any claim of the type(s) outlined in subsection (a) whatsoever arising from my participation in amateur or professional Muay Thai fights which may or may not be sanctioned by Muaythai Australia and/or PTJ Muaythai Gym; and
c) Any claim for personal injury sustained by myself in, on or about the place of training or venue of competition, its facilities and within the vicinity of the aforementioned places including (without limiting the generality of the foregoing) any claims for personal injuries resulting from and arising out of the negligence of the Trainer(s), its employees, agents or representatives; and
d) Any other liability, loss, claims, demand or right of action arising from my participation and training in the sport whatsoever.
2) I hereby acknowledge that the use of any facilities by me for training and competition and all other facilities are entirely at my own risk.
3) I hereby acknowledge that:
a) will be bound by all the rules and regulations of the Muaythai Australia Federation and its parent bodies
b) I am not an employee of the Trainers, Promoters or the Federation.
c) My participation of the sport is purely voluntary and for my own personal Interest and benefit.
d) I will uphold the integrity of the sport, maintain and promote its excellence.
4) I understand that it is my responsibility to hold a current medical certificate to be entitled to train and should I be unable to present a current medical certificate or fail to sign the Federation’s waiver then I will be refused the right to fight at any promotion or event sanctioned by the Federation.
5) I acknowledge that in signing this waiver I am subject to the Civil Liability Act 2002 (NSW) and I acknowledge absolutely I have given up my rights to damages for any injuries I may sustain as a result of my participation in this recreational activity.
In preparation for physical activity, please tell us about ALL of your existing medical and physical conditions, and who to contact in an emergency. It is your responsibility to complete this form before participating in any physical activity. For any conditions that can be affected by exercise, you may be asked to consult your doctor and obtain a written medical clearance to exercise. Please give this clearance to your Coach. The information contained will be treated as confidential and only revealed to relevant team players (staff) for your safety.
Please note that it is your responsibility to inform us of any changes in your medical or physical condition during your studies with the Institute.
DO YOU HAVE, OR HAVE YOU HAD, ANY OF THE FOLLOWING CONDITIONS? TICK EITHER YES OR NO
DO YOU HAVE, OR HAVE YOU HAD, ANY JOINT PROBLEMS, PAINS OR INJURIES IN ANY OF THE FOLLOWING REGIONS?
I understand that I may participate in physical activities which may expose me to certain risks and that I do so at my own risk. I will not hold PTJ Muaythai Gym, or any of its servants and agents, liable for any injury, loss, damage or death caused to me or my property whether by negligence, omission, and breach of contract or in any way whatsoever.
I, (full name), undertake to complete a new pre-activity questionnaire in the event of any change in my medical status during the course. I understand that it is my responsibility to advise PTJ Muaythai Gym of any medical/physical conditions that may prevent me from exercising, and that I participate in exercise at my own risk.