I, , on behalf of myself, members of my family, executors, administrators, and assigns, hereby indefinitely and forever release from liability, discharge from responsibility, and hold harmless West County Brazilian Jiu Jitsu LLC (located at 132 Weeks Way, Sebastopol, CA, 95472) its owner(s), employees, representatives and agents for any injury, loss or damage to my person or property howsoever caused, arising from or in connection with my, or the person(s) under my guardianship, taking part in classes, self-defense workshops, seminars and/or other activities occurring inside or outside of the West County Brazilian Jiu Jitsu LLC training facility. Notwithstanding that, the same may have been contributed to or occasioned by the negligence of West County Brazilian Jiu Jitsu LLC., its owner(s), employees, representatives, and agents.
I understand that Jiu-Jitsu and Kickboxing/Bando are physical activities wherein permanent physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis), economic or emotional loss, and death can occur as a result of my actions as well as the actions of other participants and that each participant, including myself, is not required to wear any protective equipment to participate but should such equipment be desired by myself that I must supply my protective equipment. Nonetheless, I assume all related risks, known and unknown to me, of my participation in Jiu Jitsu, Kickboxing/Bando, Martial Arts, Self Defense, and/or fitness, including travel to, from, and during this Activity. I acknowledge that West County Brazilian Jiu Jitsu LLC and its directors, officers, volunteers, representatives, and agents are not responsible for errors, omissions, acts, or failures to act of any party or entity conducting a specific event or activity on behalf of West County Brazilian Jiu Jitsu LLC.
I acknowledge that this Activity may involve a test of a person’s physical and mental limits and may carry the potential for death, serious injury, and/or property loss. The risks may include but are not limited to, those caused by terrain, facility, equipment(s), temperature, weather, hydration, health condition of participants, volunteers, spectators, coaches, event officials, event monitors, and/or producers of the event. I agree to indemnify and to hold harmless West County Brazilian Jiu Jitsu LLC. against all claims, suits, or actions of any kind whatsoever for liability, damages, compensation, or otherwise brought by me or anyone on my behalf, including attorney fees and any related costs, if litigation arises pursuant of any claims made by me or by anyone else acting on my behalf. If West County Brazilian Jiu Jitsu LLC. incurs any of these types of expenses, I agree to reimburse the West County Brazilian Jiu Jitsu LLC.
The undersigned acknowledges that the waiver was read, understood, and agrees to abide by it and that they are 18 years of age or older and/or the legal guardian of the student named in this form with authority to grant said student with permission to participate in activities facilitated by West County Brazilian Jiu Jitsu LLC. and its staff.
Participating Minor(s):