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ORANGEVILLE ​BRAZILIAN JIU JITSU ACADEMY INC. ​ACKNOWLEDGEMENT​ ​AND​ ​RELEASE 

WAIVER​ ​&​ ​ACKNOWLEDGEMENT​ ​AND​ ​RELEASE

In signing this document you are waiving the right to bring a court action to recover compensation or obtain any other remedy for; personal injuries, damage to property, loss of property, accident of any kind, or death, arising out of your use of Orangeville Brazilian Jiu Jitsu Academy Inc., here-after referred to as Orangeville BJJ. This includes Orangeville BJJ’s: facilities, equipment, your participation in classes, or activities sponsored by Orangeville BJJ (including but not limited to tournaments, boot camps, seminars, clinics, workshops, martial arts classes, and special events), whether supervised or unsupervised. You must be 18 years of age or older to sign this Acknowledgement and Release, otherwise a parent or guardian must sign on your behalf. 

ACKNOWLEDGEMENT​ ​AND​ ​RELEASE

Orangeville BJJ operates facilities ("Gym") and equipment located at 75 First st. Orangeville, Ont., and may provide classes or activities whether supervised or unsupervised by Orangeville BJJ's employees or agents (collectively the "Gym Activities"). AND WHEREAS an essential condition for Orangeville BJJ permitting me to use its facilities and/or participate in Gym Activities, I have agreed to give this Acknowledgement and Release. NOW THEREFORE, IN CONSIDERATION of Orangeville BJJ permitting me to use the Gym and participate in Gym Activities, I, for myself, my personal representatives, assigns, and heirs: (1) ACKNOWLEDGE, agree and represent that I understand the nature of the Gym and Gym Activities that I am in good health and in proper physical condition to use the Gym and participate in Gym Activities. (2) I fully understand that; A). The Gym and Gym Activities may involve serious risks and dangers of serious bodily injury, including permanent disability, paralysis, and death (the "risks"). B). These risks may be caused by my own action, the actions or inactions of others using the Gym or participating in the Gym Activities, the condition of the Gym or the condition in which the Gym Activities take place, or the negligence of the releases listed below and the following page. C). There may be other special or unusual risks associated with the Gym or Gym Activities, including social or economic losses, either known to me or not readily foreseeable at this time: AND I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR ALL LOSSES, COSTS, AND DAMAGES I MAY INCURE AS A RESULT OF MY USE OF THE GYM OR MY PARTICIPATION IN THE GYM ACTIVITIES BOTH NOW AND IN THE FUTURE. (3) AGREE AND WARRANT that I will examine and inspect all gym equipment and each Gym Activity in which I take part and that, if l observe any condition which I consider to be hazardous or dangerous, I will notify the proper authority in charge of the Gym or Gym Activities, as the context requires, and will refuse to use such equipment or take part in such Gym Activities until the condition has been corrected to my satisfaction. (4) HEREBY RELEASE, discharge and covenant not to sue Orangeville BJJ, its officers, directors, shareholders, employees, volunteers, instructors, participants in Gym Activities, users of the Gym, assigns, owners and lessors of the facility where the Gym is located, all designers, manufacturers and installers of equipment and other fixtures located at the Gym's facilities (collectively referred to as the "releases") from all liability, claims, causes of action, demands, losses or damages on my account caused, or alleged to have been caused, by in whole or in part by my use of the Gym, my participation in Gym Activities or the negligence of the releases or otherwise, I further agree that if despite executing this acknowledgement and release I or anyone on my behalf, makes a claim against any of the releases, whether directly or indirectly, I will indemnify, save and hold harmless each of the releases from any litigation expense, solicitor fee, loss, liability, damage or cost which may be incurred as a result of such claim. (5) CHOICE OF LAW AND ATTORNMENT- This acknowledgement and release shall be governed by and construed in accordance with the laws of the province of Ontario and the laws of Canada applicable within. I agree that the courts of the province of Ontario will have exclusive jurisdiction to determine all disputes and claims arising between the parties. (6) SUCCESSORS AND ASSIGNS- This acknowledgement and release shall be binding upon myself, my personal representatives, assigns, and heirs and shall endure the benefit of Brampton BJJ and its respective heirs, executors, administrators, directors, successors, assigns and legal representatives. (7) I understand and agree that as a club member or visitor I may be photographed, videotaped, contacted by email or other means, or have my likeness recorded by other means and used for commercial purposes including but not limited to marketing, instructional products, and internet applications. I have read this acknowledgement and release fully understand its terms and understand that I have given up substantial rights by signing it, and have signed it freely and without any inducement or assistance of any nature and intend it to be irrevocable and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this acknowledgement and release is held to be invalid, the balance of the acknowledgement and release shall continue in full force and effect. 

Dated: April 25, 2024

 

First Participant's Name

First Name*

Last Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

Email
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Where did you hear about Orangeville BJJ
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*

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.


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