To be filled in by all sumo wrestling participants prior to commencement of activities.



     

    Acknowledgment, waiver and release.

    This acknowledgment, waiver and release must be signed by participants aged 18 years or over, or by the participant’s parent or guardian on the participant’s behalf if the participant is under 18 years of age.

    Please read carefully before signing acknowledgment, waiver and release from liability and potential claims based on negligence or other misconduct.

    I certify that I am physically fit and of sufficient health to participate in this activity and have not been advised otherwise by a qualified medical person.

    I take the actions specified below for myself, my executors, administrators, heirs, next of kin, successors and assigns:

        (a)  WAIVE, RELEASE AND DISCHARGE from any and all liability for death, disability, personal injury, property damage, property theft and all other foreseeable risks or claims or actions of any kind (including breach of contract and negligence) whatever and however occurring which I at any time had or have as a result of, or in connection with, directly or indirectly, my participation in and my traveling to and from this activity, the following persons or entities: Canberra Sumo Suits and their directors, employees, independent contractors, representatives, agents and volunteers; and

        (b)  INDEMNIFY AND HOLD HARMLESS the persons or entities mentioned in paragraph (a) above from any and all liabilities, claims and actions (including negligence) whatever and however caused arising as a result of or in connection with, directly or indirectly. My participation in and traveling to and from, this activity, including any claim by any person assisting me.

    I understand that during the activity or related activities I may be photographed or filmed. I agree to allow my photograph, video or film likeness to be used for any legitimate purpose by Canberra Sumo Suits

    I have carefully read this entire form and agree to abide by all the rules and directions outlined in it.

    Participant Name (Please Print): _________________________________________________

    Signed: ______________________________________Date: _______________

    Participant/Parent/Guardian (please circle whichever is applicable)