Brazilian Jiu-Jitsu Waiver - Flow Brazilian Jiu Jitsu

 

I, _____________________________________ entirely upon my own initiative and risk and responsibility am about to participate in Brazilian Jiu-Jitsu training at Flow Brazilian Jiu Jitsu with Hayden D Martz Jr. I am at least 18 years of age. If I am under 18 years of age, a parent or guardian will sign below on my behalf.

I understand that Brazilian Jiu-Jitsu can cause serious injury or even death. I will be learning to immobilize an opponent by choking them unconscious or causing major trauma to joints such as the shoulder, knee, or elbow. At some point everyone who trains in Brazilian Jiu-Jitsu long enough will suffer at least a minor injury. Knowing all of the above, I freely choose to participate in class and acknowledge my risk.

Therefore, I do hereby for myself, my heirs, executors, and administrators release and hold harmless Flow Brazilian Jiu Jitsu, FBFC LLC and its board memebers, the head instructor Hayden D Martz Jr, and any guest instructors from any and all liability, negligence, claims, demands, actions or causes of actions, or caused of actions resulting from any participation in this sport/activity/class and associated activity.

Signature (guardian if child under 18) ___________________________________________ Date: ______________________

Contact Info:

Student's Name:____________________________________________________

Guardian's Name (if under 18): _________________________________________

Address: ____________________________ City:__________________________

State: ______________ Zip: _____________________

Email: ______________________________ Cell# ________________________

Emergency Contact: _________________________ Cell# __________________

** BRING THIS COMPLETED FORM TO YOUR FIRST CLASS** **PLEASE DO NOT ENTER THE MATTED AREA WITHOUT HANDING IN THE FORM **