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PLEASE READ CAREFULLY

THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS

WAIVER / RELEASE / ASSUMPTION OF RISK

I understand and have had explained to me that the martial art known as “Gracie Jiu-Jitsu” or “Brazilian Jiu-Jitsu” is taught using all precautions to avoid any injuries.  However, it may entail some risk of accident or injury and that this may be serious or even fatal as a consequence of the practice of the aforementioned “Gracie/Brazilian Jiu-Jitsu.”

I understand and have had explained to me that, along with the possibility of personal injury, injury to property is also possible--such as, but not limited to, the possible loss of wages and the ability to earn such wages. 

With full knowledge of the aforementioned dangers, both to my person and my property (current and future), and after having these dangers fully explained to myself and/or my legal guardian.

I hereby certify and declare that I will release and forever hold free and discharge from any liability Grounded Grit LLC and each of their agents, stockholders, directors, officers, employees, and representatives of and from all claims, demands, rights, and causes of action of any nature whatsoever which may have or which may hereafter accrue to me, arising from and by reason of any and all bodily or personal injury, damage to property or other loss and any consequence thereof, whether known or unknown, seen or unforeseen, resulting from my participation in Gracie/Brazilian Jiu-Jitsu, their persons and entities mentioned above. 

Further, knowing and understanding these risks, I hereby agree to voluntarily assume these risks and to release and hold harmless all persons or entities mentioned above whom might otherwise be liable to me for damages.  It is further understood that this waiver, release and assumption of risk is forever-binding for my heirs and assigns. I also understand and acknowledge that I have and will maintain appropriate medical insurance during classes/training.

I am also aware that for purposes of safety, security, and quality control there are I may be subject to photography or video filming. It is further understood that I will not film or photograph any classes/training without prior permission from Grounded Grit LLC.

I understand that Grounded Grit LLC crosschecks all of its students with the national sex offender database (NSOPW.gov) for the safety of its students and integrity of its business. I understand that Grounded Grit LLC reserves the right to refuse or restrict membership for any individual who has been convicted of a sex offense crime. 

My signature on this document is evidence that I know and understand and have had this document explained to me, that I fully understand the dangers that are inherent in this martial art and that I voluntarily certify that I will not hold Grounded Grit LLC, Alex Ueda, their agents and/or assigns, responsible for any injury whether as a result of training or not.  In addition, I agree to the policies applied for all students of Grounded Grit LLC presented at the time of registration and future changes implemented.

STUDENT NAME: {name}

Date: {sign_date}

(Guardian signature required if student is less than 18 years of age)