Brazilian Jiu-Jitsu (BJJ) Participation Waiver and Release of Liability
Participant Information
First Name: {first_name}
Full Name: {name}
Date of Birth: {dob}
Address: {address}
Phone Number: {phone}
Emergency Contact Information
Emergency Contact Name: {contact_name}
Emergency Contact Phone: {contact_phone}
Relationship to Participant: {contact_relation}
1. Acknowledgment of Risks
I, {name}, understand that Brazilian Jiu-Jitsu (BJJ) is a physically demanding activity that involves inherent risks, including but not limited to:
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Bodily injury, including sprains, strains, fractures, dislocations, and other serious injuries.
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Risk of injury from training partners, instructors, or equipment.
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Risk of injury due to the nature of grappling, submissions, and sparring.
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Potential for communicable diseases or infections due to close physical contact.
I acknowledge that these risks are inherent to the practice of BJJ and voluntarily assume all risks associated with participation.
2. Release of Liability
In consideration of being allowed to participate in BJJ classes, events, and activities at Midwest BJJ, LLC and all of its instructors, volunteers, and helpers, I hereby release, waive, discharge, and hold harmless the following parties from any and all liability, claims, demands, actions, or causes of action arising out of or related to any loss, damage, or injury, including death, that may be sustained by me or my property while participating in BJJ activities:
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Midwest BJJ, LLC and all of its instructors, volunteers, and helpers, its owners, operators, instructors, staff, and affiliates.
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Other participants, training partners, and visitors.
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Any facility where BJJ activities are held.
This release of liability applies to all claims, whether caused by negligence, breach of contract, or otherwise, except for gross negligence or intentional misconduct.
3. Assumption of Responsibility
I agree to take full responsibility for my own safety and well-being during BJJ activities. I agree to:
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Follow all instructions, rules, and guidelines provided by instructors and staff.
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Inform instructors of any pre-existing medical conditions, injuries, or limitations that may affect my ability to participate safely.
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Use all equipment properly and report any unsafe conditions or equipment to staff immediately.
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Refrain from training if I am feeling unwell, injured, or under the influence of drugs or alcohol.
4. Medical Treatment Authorization
In the event of an emergency, I authorize Midwest BJJ, LLC and all of its instructors, volunteers, and helpers and its staff to seek and obtain medical treatment on my behalf. I agree to bear all costs associated with such medical treatment and release the academy from any liability related to such decisions.
5. Photo/Video Release
I grant Midwest BJJ, LLC and all of its instructors, volunteers, and helpers the right to photograph, record, or video my participation in BJJ activities. I understand that these materials may be used for promotional, educational, or marketing purposes without compensation to me.
6. Governing Law
This waiver shall be governed by and construed in accordance with the laws of the state of Iowa. Any legal action arising from this agreement shall be brought in the appropriate courts of Iowa.
7. Acknowledgment of Understanding
I, {name}, have read this waiver in its entirety and fully understand its terms. I acknowledge that I am giving up substantial rights, including the right to sue. I sign this waiver freely and voluntarily without any inducement, assurance, or guarantee being made to me.
Participant Signature:
Date: {sign_date}
Parent/Guardian Signature (if participant is under 18):
Date: {sign_date}
Additional Options
