Participant Information
‍Name:
Date of Birth:
Address:
‍Phone:
Email:
‍Emergency Contact Information
‍Name:
Relationship:
Phone:
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‍Acknowledgment of Risks: I, the undersigned, acknowledge and agree that the practice of Jiu Jitsu and other martial arts activities involve inherent risks that include, but are not limited to, physical injury, disability, or death. I understand that these risks may result from my own actions, the actions or inactions of others, or the conditions of the environment or equipment.

‍Release of Liability: In consideration of being permitted to participate in classes, training sessions, tournaments, and other activities at 10th Planet Jiu Jitsu Beaumont, I hereby release, waive, and discharge 10th Planet Jiu Jitsu Beaumont, its instructors, agents, employees, and other participants from any and all liability, claims, demands, actions, or causes of action arising out of or related to any loss, damage, injury, or death that may be sustained by me, whether caused by negligence or otherwise, while participating in such activities or while on the premises.Assumption of RiskI voluntarily assume full responsibility for any risks of loss, property damage, or personal injury, including death, that may be sustained by me as a result of participating in these activities. I acknowledge that I am physically fit and do not have any medical condition that would prevent my participation in Jiu Jitsu or other related activities.IndemnificationI agree to indemnify and hold harmless 10th Planet Jiu Jitsu Beaumont, its instructors, agents, and employees from any loss, liability, damage, or costs, including court costs and attorney fees, that may arise due to my participation in these activities, whether caused by negligence or otherwise.

‍Consent for Medical Treatment: I hereby give my consent for emergency medical treatment to be rendered as necessary. I understand that 10th Planet Jiu Jitsu Beaumont does not carry medical insurance for participants and that I am expected to have my own medical insurance coverage.

‍Parental Consent (For Participants Under 18): As the parent or legal guardian of the minor participant named above, I hereby agree to the above terms and conditions. I consent to the minor's participation in Jiu Jitsu and other martial arts activities and agree to release, waive, and discharge 10th Planet Jiu Jitsu Beaumont from any and all liability, claims, demands, actions, or causes of action arising out of the minor’s participation, whether caused by negligence or otherwise.

‍Photography and Video Release: I grant 10th Planet Jiu Jitsu Beaumont permission to use my or my child’s photograph, video, or likeness for promotional purposes, including but not limited to social media, websites, and other marketing materials.

‍Acknowledgment of Understanding: I have read this Waiver and Release of Liability and fully understand its terms. I understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing this agreement freely and voluntarily and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.
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Participant Signature:
Date:
Parent/Guardian Signature (if under 18):
‍Date:

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