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WAIVER OF RIGHTS AND ALL POSSIBLE CLAIMS: The person and the parent/legal guardian signing below (if the participant is a minor or under other legal disability) states that he/she understands that neither the B.A.S.I.C - SELF DEFENSE TRAINING program, it's instructors, nor the training facility is or shall be responsible or liable for any illness, injury to person, or loss of or damage to property resulting in any way from the program in which he/she is participating. The participant and the parent/legal guardian signing below (if the participant is a minor or under other legal disability) hereby forever releases and holds harmless the B.A.S.I.C - SELF DEFENSE TRAINING program, it's instructors, and the training facility, and each of them, (and each organization's employees, agents and other representatives) from any and all claims of any kind that the participant and the person signing below (or their respective heirs, executors, administrators, or assigns) may have or claim to have based on his/her participation in such program. Each participant must sign this Waiver. If participant is younger than 18 years of age, his or her parent or legal guardian must sign this Waiver. You must bring the completed Waiver with you to the program or you cannot participate. Thank you.

PARTICIPANT'S NAME (PLEASE PRINT)              SIGNATURE                                    DATE

________________________________         ________________________       ____________

If participant is younger than 18 years of age, parent or legal guardian also must sign.

PARENT/GUARDIAN'S NAME (PLEASE PRINT)    SIGNATURE                                    DATE

________________________________         ________________________       ____________