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    I, the undersigned, acknowledge that I am applying for instruction in Stage Combat involving strenuous exercise and personal body contact. I understand that because of this there is always an inherent risk of injury that cannot be eliminated. Such injuries may include, but are not limited to, pulled muscles, dislocated joints and broken bones.

    In accordance with the law, this course does not exclude individuals with medical conditions that do not pose a medically recognized threat to the health or safety of other students in the normal course of training. I understand that there are some unavoidable circumstances where these conditions may require special caution on my part to minimize danger to myself or to others, and I acknowledge that it is my responsibility to act accordingly.

    In particular, I understand that some students may be infected with diseases like HIV/Aids and Hepatitis that can be transmitted by exchanges of blood or other bodily fluids and that I may be training with them.

    As a condition to being admitted to the class as a student, I assume the risk of all injuries and do hereby hold Aaron Preusse, his assistants, The Fake Fighting Company, The Society of American Fight Directors its employees and agents harmless from any and all liability due to injuries suffered by me or caused by third parties to me, arising out of activities involving Stage Combat, or any variation thereof, whether occurring on the premises of the classes or elsewhere.

    Blood-Borne Pathogen Policy

    To protect the students and staff against disease, Aaron Preusse and the Fake Fighting Company, LLC have adopted the following policy intended to minimize the risk of transmission of HIV, Hepatitis-B, and other blood-borne pathogens during training activities. Current available medical evidence suggests that the risk of transmission of HIV during the type of body contact that occurs in Stage Combat training is extremely slight. Organizations such as the NCAA, the National Academy of Pediatrics Committee on Sports Medicine and the U.S. Olympic Committee have concluded that persons infected with blood-born pathogens, particularly HIV, should not be barred from participating in contact sports. Certain federal and state anti-discrimination laws may also prohibit such a ban. These organizations have concluded that the already-slight risk of transmission of HIV, and other blood-born diseases, can be reduced further by adoption of the Center for Disease Control-recommended "universal precautions" with regard to bodily fluids.

    Aaron Preusse and the Fake Fighting Company, LLC will observe these "universal precautions." Generally, this means that instructors and all persons training with these classes shall treat all exposed bodily fluids as if they are infected. Specifically, the following measures will be observed at all times:

    1. If you have any open cuts or sores, you must clean them with a suitable antiseptic and cover them with a leak-proof dressing before training. Make sure they stay covered while you are training. If your hands have broken skin, suitable gloves may be worn to cover these areas. If you notice that some- one else has an open cut or sore, remind her or him of this obligation before training with that person.

    2. If a bleeding wound, even a minor one, occurs during training, the person bleeding shall immediately stop training, and leave the training area until the bleeding stops and the wound is securely covered. Immediate measures shall be taken to stop the bleeding. If the person needs assistance with this, each person assisting shall wear a pair of latex gloves (which are available in the class first aid kit). Hands shall be washed with soap and hot water immediately after gloves are removed. All used gloves, and bloody rags or dressings, will be placed in a leak-proof plastic bag provided for that purpose, and disposed of carefully. Minor bloodstains on clothing should be treated with a disinfectant solution provided for that purpose. If there are major bloodstains, the clothing shall be removed as soon as practicable, placed into a leak-proof container, and handled carefully until it can be laundered or disposed of.

    3. If you come into contact with the blood of another, you shall immediately stop training, leave the training area, and wash the exposed area thoroughly with soap and hot water before returning.

    4. If blood is present in the training area, the training partner of the person bleeding should insure that no one inadvertently comes in contact with the blood. The blood should be cleaned up as soon as possible by wiping down the exposed surface with a disinfectant solution provided for that purpose. Each person assisting with the task shall put on a pair of latex gloves, and shall wash their hands with soap and hot water immediately after the gloves are removed. It is preferable however, that the person bleeding cleans up his or her own blood. Bloody rags and used gloves shall be disposed of as set out in Paragraph 2.

    Finally, there are other diseases and illnesses aside from those known to be transmitted through blood. You are reminded that you are responsible for not only your own health and safety, but the health and safety of others with whom you train. If you know or suspect that you have any illness or disease which might infect others, refrain from training until you are not a risk to others.

    Thank You!