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PLEASE READ CAREFULLY THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS
I understand and have had explained to me that the martial arts known as “Gracie Jiu-Jitsu” and “Shotokan Karate” is taught using precautions to avoid any injuries. However, participation in the Gracie Jiu-Jitsu and /or Shotokan Karate classes carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. The specific risks range from minor injuries such as scratches, bruises, and sprains, to major injuries such as eye injury or loss of sight, joint or back injuries, heart attacks, and concussions, to catastrophic injuries including paralysis and death. Furthermore, I understand the practice of Gracie Jiu-Jitsu and /or Karate presents a risk of skin infections, communicable diseases, bacteria(s) and viruses, including, but not limited to, the corona virus.
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, possible loss of wages and the ability to earn such wages. With full knowledge of the aforementioned dangers, both to my person and to my property (current and future), and after having these dangers fully explained to myself and/or to my legal guardian:
(Name of Legal Guardian), I nevertheless desire to participate in Gracie Jiu-Jitsu and /or Shotokan Karate training and activities.
I hereby certify and declare that I will release and forever hold free and discharge from any liability Gracie Global LLC, d.b.a. Gracie University, and each of their owners, 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 Jiu-Jitsu and /or Karate, their persons and entities mentioned above, including and not limited to any negligence on the part of Gracie University, their owners, agents stockholders, directors, officers, employees, volunteers representatives.
I hereby certify and declare that I will release and forever hold free and discharge from any liability Metro Jiu Jitsu LLC, d.b.a. Metro Karate & Jiu Jitsu Academy, and each of their owners, 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 Jiu-Jitsu and /or Karate, their persons and entities mentioned above, including and not limited to any negligence on the part of Gracie University, their owners, agents stockholders, directors, officers, employees, volunteers representatives.
I understand that Gracie University crosschecks all of its students with the national sex offender database (NSOPW.gov) for the safety of its students. I understand that Gracie University reserves the right to refuse service to any individual who has been convicted of a sex crime.
Further, knowing and understanding these risks, nevertheless I hereby agree to voluntarily assume these risks and to release and hold harmless all the 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 on my heirs, assigns, executors, administrators and representatives. 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 surveillance cameras mounted throughout Gracie University and Metro Karate & Jiu Jitsu Academy. Furthermore, I understand and acknowledge that often times video recording or photographs may be taken of me during classes/training. I hereby grant Gracie Global LLC, d.b.a. Gracie University and Metro Jiu Jitsu LLC, d.b.a. Metro Karate & Jiu Jitsu Academy the unlimited use of my likeness in any format photo, video, or other, for promotional advertisement or commercial use in any format known or yet to be developed in perpetuity, and I forfeit any form of payment. It is further understood that I will not video record or photograph any classes/training without prior permission from Gracie University.
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 these martial arts and that I voluntarily certify that I will not hold Gracie Global LLC, d.b.a. Gracie University, Rener Gracie, Ryron Gracie, the Gracie family, their owners, agents, staff, volunteers, and/or assigns, Metro Jiu Jitsu LLC, d.b.a. Metro Karate & Jiu Jitsu Academy, David Toft, the Toft family, their owners, agents, staff, volunteers, and/or assigns,responsible for any injury whether as a result of training or not, including, but not limited to, any loss of personal property.
If no Children please put NA in both first and last name of the "PRINT NAME of Child" line.
PRINT NAME of Child: NA
Adult / Guardian Name:
Adult/Guardian Signature Below: