WAIVER AND RELEASE OF LIABILITY
In Consideration of Brotherhood BJJ allowing me to participate, I acknowledge and understand that I have voluntarily chosen to participate in training activities provided by Brotherhood BJJ, hereinafter referred to as “the gym”
I agree that the gym is in no way responsible for the safekeeping of my personal belongings while I attend class.
I agree that I will obtain a physical examination from a doctor before suing any exercise equipment or participating in any exercise activity.
I understand that the training may involve weightlifting, gymnastics movements, fighting, strenuous bodyweight exercise and other high exertion activities, and that I am not obligated to perform nor participate in any activity that I do not wish to do, that it is my right to refuse such participation at any time during my training sessions. I understand there are inherent risks in all aspects of physical training and I acknowledge that I have been informed of the possible strenuous nature of the training and the potential for undesirable physiological results including, but not limited to, abnormal blood pressure, muscle soreness, fainting, heart attack and/or death.
I understand that should I feel lightheaded, faint, dizzy, nauseated, or experience pain or discomfort, I am to stop the activity and inform my trainer, I give the gym and the staff of the facilities I train in permission to seek emergency medical services for me should I become injured or ill with the understanding that I am responsible for any expenses incurred. If I am signing on behalf of a minor child, I also give full permission for any person connected with the gym to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical and/or surgical care for the child and to transport the child to a medical facility deemed necessary for the well-being of the child.
I agree to WAIVE ANY AND ALL CLAIMS that I have or may have in future against the gym, and its directors, officers, employees, agents, volunteers and independent contractors( all of whom are hereinafter collectively referred to as “the Releasees”). I agree to RELEASE the RELEASEES from any and all liability for any loss, damage, injury or expense that I may suffer, or that my next of kin may suffer as a result of my participation in the programs, activities and services provided by the gym, due to any cause whatsoever including negligence, breach of contract, or breach of any statutory or other duty of care.
I agree to HOLD HARMLESS AND INDEMNIFY THE RELEASEES from any and all liability for any damage to the property of, or personal injury to, any third party, resulting from my participation in any program, activity or service provided by the releases. This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferee. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect.
I HAVE READ AND UNDERSTOOD THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS “INFORMED CONSENT FORM” I AM WAIVING CERTAIN LEGAL RIGHTS (INCLUDING THE RIGHT OT SUE) WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTOR, ADMINISTERS AND ASSIGNS MAY HAVE AGAINST THE RELEASEES, ANY QUESTIONS I HAD WERE ANSWERED TO MY FULL SATISFACTION.
Name: _____________________
Signature: ____________________
Date: _______________________
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