WAIVER, RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND AGREEMENT TO PARTICIPATE
MACB JJ, LLC/BRAZIL-021 HOUSTON SCHOOL OF JIU-JITSU
In consideration of being allowed to participate in any and all activities, training, competitions, and sanctioned events of MACB JJ, LLC/Brazil-021 Houston School of Jiu-Jitsu;
(Adult Student/Minor Student), {name}.
(If minor student listed in student details, parent or legal guardian agrees to the following with signature listed below) I hereby agree to the following:
Student Details
{name}
{dob}
{address}
{phone}
1. I hereby attest and confirm that I am entering into and signing this Waiver, Release
of Liability, Assumption of Risk, and Agreement to Participate under my own free
will, sound mind and body, and without any duress, pressure, or coercion by, or
anyone acting on behalf of, MACB JJ, LLC/Brazil-021 Houston School of Jiu-Jitsu.
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2. I certify that I am in good physical and mental condition, and have no disease, injury, or other ailment or illness that would impair my performance or physical and mental well-being during any and all trainings, private lessons, and/or competitions.
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3. I hereby recognize and understand that martial arts training is a physical contact activity. My participation in martial arts might result in serious injury including, but not limited to, permanent disability, death, and/or severe social and economic loss. I personally assume these risks under my own free will, and without any duress, pressure, or coercion by, or anyone acting on behalf of, MACB JJ, LLC/Brazil-021 Houston School of Jiu-Jitsu.
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4.I hereby recognize that there may be other risks that are not known to me or to others or not reasonably foreseeable at this time.
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5. I agree and have the right to inspect the facilities and equipment, prior to participation. I agree and have the right to inform the instructor(s) if I believe that anything is unsafe and/or beyond my ability, skill, or fitness level. If I believe that anything is unsafe or beyond my ability, skill, or fitness level, I have the to right to refuse to participate for my own protection.
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6. I assume any and all risks, known and/or unknown, and accept personal responsibility that may result from injury, permanent disability, social and economic loss, and/or death.
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7. I enter martial arts training, private lessons, and /or competitions entirely of my own free will and understand the importance of following the rules of training, private lessons, and competition.
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8. Should I wish to enter martial arts competitions, it is wholly, completely, and absolutely my decision to do so. I understand that entering into martial arts competitions is not a condition, prerequisite, and/or obligation of continued membership of MACB JJ, LLC/Brazil-021 Houston School of Jiu-Jitsu.
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9. The rules and regulations of MACB JJ, LLC/Brazil-021 Houston School of Jiu-Jitsu have been explained to me. I have been given the opportunity to ask questions, express concerns, and/or clarify misunderstandings thereof. My questions and concerns have been answered and I understand the rules and regulations of MACB JJ, LLC/Brazil-021 Houston School of Jiu-Jitsu.
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10. I hereby grant permission in case of an emergency to have a doctor, nurse, athletic trainer, chiropractor, physical therapist, or any other medical personnel to provide me with assistance or treatment of injuries sustained in any trainings, private lessons, and/or competitions.
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11. I agree to give permission, free of charge, with no promise, representation or expectation of any form of compensation, to use my likeness in any and all photos, pictures, videos, media, advertisements, instructional videos, online training programs, and/or marketing materials to promote martial arts sports, fitness, and or MACB JJ, LLC/Brazil-021 Houston School of Jiu-Jitsu.
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12. I agree to abide by all rules governing the conduct and operation of instruction, respect for the other students and observers, promotion tests, and/or any and all similar activities, as may be prescribed by MACB JJ, LLC/Brazil-021 Houston School of Jiu-Jitsu.
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13. I acknowledge that instruction in Brazilian Jiu-Jitsu is for the purpose of self-defense, recreation, sport, and amateur competition, and not to for the purpose of using instruction for teaching Brazilian Jiu-Jitsu.
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14. I hereby agree to release, waive, discharge, indemnify, hold harmless, and not to sue or commence any other legal action, against MACB JJ, LLC/Brazil-021 Houston School of Jiu-Jitsu, its affiliated organizations and governing bodies, its officers, instructors, personnel, other members of the organization, participants, supervisors, instructors, coaches, sponsoring organizations, or their agents, and if applicable, owners and/or leasers of premises from any and all liabilities; for any and all claims, demands, losses and damages, which may be sustained and suffered on account of injury, including, but not limited to, death or damage of property, caused or alleged to be caused, in whole or in part, by negligence of persons, personnel, governing bodies, instructors, agents, officers, employees, assigns, independent contractors, representatives, other students, and/or anyone acting on behalf of MACB JJ, LLC/Brazil-021 Houston School of Jiu-Jitsu.
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Emergency Contact
In the event of an emergency, {contact_name}, {contact_relation}, is the best form of contact and will be contacted at {contact_phone}.
{sign_date}
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS WAIVER, RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND AGREEMENT TO PARTICIPATE. I FURTHER ACKNOWLEDGE MY UNDERSTANDING OF THIS WAIVER, RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND AGREEMENT TO PARTICIPATE AND CONSENT TO ALL THE TERMS CONTAINED HEREIN. I HEREBY CONSENT TO THE USE OF AN ELECTRONIC SIGNATURE TO RECORD MY COMMITMENT TO THESE TERMS.
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Electronic Signature Consent
By initialing below, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.
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*Must be 18 years or older to sign the waiver.
*Parent or guardian of student under 18 years of age.