Loading...

Release of Liability Assumption of Risk

Using the BJJTECHNICS facilities involves the risk of injury to you or your guest, whether you or someone else causes it.

Specific risks vary from one activity to another and the risk range from minor injuries to major injuries, such as catastrophic injuries including death.

In consideration of your participation in the activities offered by BJJTECHNICS, you understand and voluntary accept this risk and agree that BJJTECHNICS, its officers, directors, employees, volunteers, agents and independent contractors will not be liable for any injury, including, without limitation, personal, bodily, or mental injury, economic loss or damage to you, your spouse, guests, unborn child, or relatives resulting from the negligence of BJJTECHNICS or anyone on BJJTECHNICS behalf or anyone using the facilities whether related to exercise or not.

Further, you understand and acknowledge that BJJTECHNICS does not manufacture fitness or other equipment at its facilities, but purchases and or leases equipment.

You understand and acknowledge that BJJTECHNICS is providing recreational services and may not be held liable for defective products.

By signing below, you acknowledge and agree that you have read the foregoing and know of the nature of the activities at BJJTECHNICS and you agree to all the terms of this agreement and acknowledge you have received a copy of it and its membership policies.

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Referral Information
How did you hear about us?*
Internet Search
Newspaper
Facebook
Twitter
Instagram
Yelp!
Referred by a friend
Other

Please complete if "Referred by a friend" or "Other"
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!