10th Planet Jiu-Jitsu/Skoll Jiu-Jitsu Inc.

Liability Waiver and Release Form

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Participant Information
Full Legal Name (This will act as your signature)

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Date of Birth *
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Phone Number *
Email Address *
Emergency Contact
Emergency Contact Full Name *
Relationship to Participant *
Emergency Contact Phone Number *
Assumption of Risk and Release of Liability 

I, the undersigned, acknowledge and understand that participation in Brazilian Jiu-Jitsu and other martial arts training at 10th Planet Richmond involves physical contact and inherent risks. These risks include, but are not limited to, serious injury, permanent disability, or death. I knowingly and voluntarily assume all such risks.

I understand that these risks may arise from my own actions or inactions, the actions or inactions of others, the rules of training, or the condition of the premises or equipment.

I hereby waive, release, and discharge 10th Planet Richmond, its owners, instructors, employees, agents, volunteers, affiliates, and representatives from any and all claims, demands, liabilities, damages, costs, or causes of action arising out of or connected with my participation in any activities or use of the facilities, whether arising from negligence or otherwise.

I have read and agree to the Assumption of Risk and Release of Liability statement above.
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Required
Health and Safety Acknowledgment 

I affirm that I am in good physical condition and do not suffer from any medical condition or illness that would prevent my participation in training. I understand I am responsible for my own health and safety, and I agree to notify instructors of any condition that may affect my participation.

I further acknowledge the contagious nature of communicable diseases (including but not limited to COVID-19) and voluntarily assume the risk of exposure or infection through participation.

I have read and agree to the Health and Safety Acknowledgment.
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Required
Acknowledgment of Understanding
I have read and fully understand this waiver and release of liability. I acknowledge that by signing this document, I am giving up legal rights and remedies that may be available to me. I certify that I am 18 years of age or older, or that my legal guardian is signing on my behalf.
I acknowledge and understand the waiver, and certify that I am 18 or older.
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Required
Date *
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Is the participant under 18 years old? *
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