Te Manawa Jiu Jitsu WAIVER
I, …………………………………………………………. entirely upon my own initiative and risk and responsibility am about to participate in Brazilian Jiu Jitsu training at Te Manawa Jiu Jitsu with Brent and Paula Te Kawa and any other Instructor. I further certify that I am at least 18 years of age. If under 18, my parent/guardian will sign below on my behalf.
To the best of my knowledge, I am in good physical condition and fully able to participate in the sport. I am fully aware of the risks and hazards connected with the participation in Brazilian Jiu Jitsu, including physical injury or even death, and hereby elect to voluntarily participate in said sport, knowing that the associated physical activity may be hazardous to me.
Therefore, I do hereby for myself, my heirs, executors and administrators release and hold harmless Te Manawa Jiu Jitsu, CTA and the head instructors Brent and Paula Te Kawa and any other Instructor, and any guest instructors from any and all liability, negligence, claims, demands, actions or causes of actions, or caused of actions resulting from any participation in the sport/activity/class and associated activity.
I am aware that choosing a membership I have the availability to place on hold for one two-week period only and if longer than two weeks the membership will restart at the current membership rate at that time..
I am aware that a belt promotion incurs a fee of $20 to cover the cost of the belt and this will be invoiced to me after being presented the belt promotion by Te Manawa Jiu Jitsu.
DATE
_______________________________________________
Signature (guardian if child under 18)
{sign_date}
Contact Information;
{name}
{address}
{phone}
Emergency Contact Informaton;
{contact_name}
{contact_phone}