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Markle BJJ Waiver & Release Form
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Student's First Name
Student's Last Name
Phone
Email
Birthday
Is the student under 18 years of age?
*
No
Yes
Please specify anything we should know about (in case of emergency)
BJJ /NoGi Program
MGT Wrestling Club
I agree and consent to the following: I recognize that the program requires physical exertion that may be strenuous at times and may cause physical injury and I am fully aware of the risks and hazards involved. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the above-mentioned program. I represent and warrant that I have no medical condition that would prevent my participation in the program. I agree to assume full responsibility for any risks, injuries or damage known or unknown which I might incur as a result of participating in the program. Such injuries may include, but are not limited to, heart attacks, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, heat prostration, injuries to knees, injuries to back, injuries to foot, or any other illness or soreness, including death. I knowingly, voluntarily and expressly waive any claim I may have against MARKLE BJJ for injury or damages that I may sustain as a result of participating in the program. I, forever release waive, discharge and covenant not to sue MARKLE BJJ for any injury or death caused by their negligence or other acts. I have read the above waiver and release of liability and fully understand it contents. I voluntarily agree to the terms and conditions stated above.
I declare that the info I’ve provided is accurate & complete
Participant’s Signature
Clear
Parent or Guardian First name
Parent or Guardian Last name
Parent or Guardian Signature (if participant is under 18 years old)
Clear
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