Annuziato Jiu Jitsu
Liability Waiver
I, the undersigned, or parent/legal guardian thereof, hereby waive all claims against any and all
persons associated with Annunziato Jiu Jitsu LLC, to include but not limited to, its employees,
agents, associates, owners, members, landlord(s), and operators. I understand that I am
participating in a martial art which includes violent physical bodily contact. I understand that
this manner of martial arts involves choke holds, arm locks, neck cranks, ankle locks, body
throws, body slams, punches, kicks, elbows, knee strikes, and other similar physical contact
which could potentially cause serious injury or even death. I understand the risk involved and
assume full responsibility for all my actions performed during this activity in connection with
Annunziato Jiu Jitsu LLC. By signing this release and consent form below, I hereby indicate that I
fully understand the risk of participating in this manner of martial arts training, and I do hereby
release Annunziato Jiu Jitsu LLC and all of its employees, agents, associates, owners, members,
landlord(s), and operators from any and all liability, claims, demands, legal actions, medical
bills, and/or any and all other causes of action whatsoever arising out of or relating to any act,
occurrence, or omission, and/or any loss, damage, or injury, including death, that may be
sustained by the undersigned, or any property of the undersigned, as a result of participating in
this manner of training.
I, the undersigned, or parent/legal guardian thereof, also do hereby state that I am in good
physical condition and know of no reason why I cannot participate in this manner of training. In
the unlikely occurrence of a medical emergency, I hereby authorize any licensed medical
personnel to perform any accepted medical assistance deemed necessary, I agree to bear the
expense of any such treatment, and hereby release Annunziato Jiu Jitsu LLC from any
obligation, financial or otherwise, resulting from such medical treatment.
As additional consideration for training at Annunziato Jiu Jitsu LLC, I agree that my attendance
and/or performance at the academy, and at any remote located events, may be photographed,
filmed and/or taped and used by Annunziato Jiu Jitsu LLC for marketing purposes. I authorize
the use of my name, image and likeness, and I waive any compensation thereof, even if I
discontinue my training at Annunziato Jiu Jitsu LLC.
I acknowledge that I would like to receive correspondence from the academy via telephone,
mail, and email.
I, the undersigned, or parent/legal guardian thereof, being duly aware of the risk and hazards
inherent with participating in martial arts, agree to all its rules, terms, requirements, and
conditions. I acknowledge that I have received a copy of Annunziato Jiu Jitsu LLC rules and
sparring rules, and that I have read them, understand them, and agree to honor and obey
them. I understand that disobeying the rules may, at Annunziato Jiu Jitsu LLC’s discretion, result
in suspension or expulsion from Annunziato Jiu Jitsu LLC, and that I will not be entitled to a
refund, and if expelled, must pay the remainder of my contract, if one has been signed.
Free trial starts the day of your introductory lesson.
In signing the foregoing release, the undersigned, or parent/legal guardian thereof, hereby
acknowledges and represents that he/she:
- has read the foregoing release and consent form,
- fully understands it in its entirety,
- has had the opportunity to ask questions and receive explanatory answers for any part
that presents uncertainty,
- is over 18 years of age and is of sound mind, and
- hereby signs it voluntarily.
If under 18, a parent/legal guardian signing this release and consent form hereby agrees to all
its terms and conditions with regards to their minor child(ren) participating in the
aforementioned activities.
**IF YOU ARE OVER THE AGE OF 18, PLEASE FILL IN THE PARENT/GUARDIAN FIELD WITH N/A**
Participant's Name:
Parent/Guardian Name:
Participant OR Parent/Guardian Signature: