YORK RIVER JIU JITSU
RELEASE OF LIABILITY WAIVER
Participant Name: {name}
Date of Birth: {dob}
Address: {address}
Phone Number: {phone}
Emergency Contact: {contact_name}
Emergency Contact Phone: {contact_phone}
Emergency Contact Relationship: {contact_relation}
I understand that participation in Brazilian Jiu-Jitsu, martial arts training, fitness activities, and related programs at York River Jiu Jitsu involves physical contact and carries the risk of injury, including but not limited to serious bodily injury, permanent disability, or death.
I voluntarily choose to participate and fully assume all risks associated with participation and training.
I agree to release, waive, and hold harmless York River Jiu Jitsu, its owner, instructors, coaches, employees, volunteers, affiliates, and representatives from any and all liability, claims, demands, injuries, damages, or losses arising from participation in classes, training sessions, competitions, events, or use of the facility.
I certify that I am physically capable of participating in martial arts activities and understand it is my responsibility to consult a physician regarding any medical concerns before participation.
I agree to follow all gym rules, safety procedures, and instructor guidance while training at York River Jiu Jitsu.
I understand that memberships and payments may be governed by separate membership agreements and policies.
PHOTO & VIDEO RELEASE
I authorize York River Jiu Jitsu to use photographs and videos taken during classes or events for marketing, social media, and promotional purposes.
I do NOT authorize the use of my photo or video for promotional purposes.
For participants under 18 years old, a parent or legal guardian must sign below.
By signing below, I acknowledge that I have read, understood, and voluntarily agree to this waiver and release of liability.
Signature:
Date Signed: {sign_date}
Initials:
