Signup

Waiver and Release of Liability

Member Information:

• Full Name: {name}
• Date of Birth: {dob}
• Address: {address}
• Phone Number: {phone}

Emergency Contact Information:

• Emergency Contact Name: {contact_name}
• Emergency Contact Phone: {contact_phone}
• Relation to Member: {contact_relation}

Assumption of Risk:

I, {first_name}, acknowledge that participation in Brazilian Jiu-Jitsu (BJJ) training at Newaza Jiu-Jitsu Academy involves physical exertion, contact, and inherent risks of injury. I am voluntarily participating in these activities with full knowledge and understanding of the risks involved.

Medical Condition:

I affirm that I am in good health and have no medical conditions that would restrict my participation in BJJ training. I agree to promptly inform the Gym of any changes in my health status.

Release and Waiver:

In consideration of being permitted to participate in BJJ training, I hereby release, waive, and discharge Newaza Jiu-Jitsu Academy LLC, its owners, instructors, employees, and agents from any and all liability for injuries or damages that may arise during or as a result of my participation.

Insurance:

I understand that I am responsible for maintaining adequate health and accident insurance coverage to cover any injury or damage that may occur during my participation in BJJ training.

Code of Conduct:

I agree to abide by the Academy's rules and regulations, understanding that failure to comply may result in expulsion from the Academy.

Authorization:

I authorize the Academy to obtain emergency medical treatment for me if deemed necessary. In case of a medical emergency, the Academy will make reasonable attempts to contact the provided emergency contact.

Signature:

By signing below, I acknowledge that I have read, understood, and agree to the terms and conditions outlined in this waiver.

• Date Signed: {sign_date}
• Signature:
• Initials: