No Gi Basics Course

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A parent or guardian must sign this waiver if the student is not yet 18 years of age.

Release and Waiver of Liability and Indemnity Agreement for Charlottesville Brazilian Jiu Jitsu, LLC.

1731 Allied Street | Charlottesville, VA 22903 | Gordon Emery, Owner & Chief Director

Read Carefully Before Signing

In consideration of (my child) being permitted to participate in any way in the martial arts program indicated above and/or being permitted to enter for any purpose any restricted area (here in defined as any area where in admittance to the general public is prohibited), I understand and agree to the following:

1. I acknowledge (will instruct my child) that prior to participating in the above martial arts activity or event, I (he or she) will inspect the facilities and equipment to be used, and if I (he or she) believes anything is unsafe, I (they) will immediately advise the officials of such condition and refuse to participate. 

2. I have already undertaken such an inspection, are satisfied with the facilities and equipment, and are permitting (my child) to participate. 

3. I understand and agree that, if at any time, I feel anything to be UNSAFE; I will immediately take all precautions to avoid the unsafe area and REFUSE TO (ALLOW MY CHILD) TO PARTICIPATE further.

4. I fully understand and acknowledge that:

1. Martial Arts and Combat Sports constitute an inherently dangerous activity, but I/we have elected to (allow our child to) participate.

2. There are risks and dangers associated with participation in Martial arts and Combat sports and all other activities which could result in bodily injury, partial and/or total disability, paralysis and death.

3. Martial arts and Combats sports are strenuous activities that involve extensive contact with other people. Actions involved, but not limited to, are as follows: Falling to the ground, limb joint locks, strangulation, asphyxiation, strikes to the face, body and limbs.

4. These risks and dangers may be caused by the action, inaction or negligence of the participant or the action, inaction or negligence of others, including, but not limited to, the Releasees named below.

5. The injuries that may occur, but not limited to, are broken bones, sprained and/or torn ligaments, strained and/or torn muscles, contusions, abrasions, eye injury or loss, concussion, paralysis, and loss of consciousness and/or death. Long-term risks that may occur, but not limited to blindness, hearing loss, hematoma of the ears, paralysis, ligament damage, joint damage, spinal damage.

6. Close physical contact has been known to spread communicable diseases, such as, but not limited to COVID-19, herpes gladiatorum, warts, ringworm, staph, MRSA, impetigo. 

7. Charlottesville BJJ has put into place preventative measures suggested by the CDC to help reduce the spread of communicable diseases, such as COVID-19. However, Charlottesville BJJ cannot guarantee that you or your children will not become infected with COVID-19. Attending any class or activity at Charlottesville BJJ could increase the risk and your children's risk of contracting COVID-19.

8. There may be other risks not known to us or are not reasonably foreseeable at this time.

9. The social and economic losses and/or damages, which could result from these risks and dangers described above, could be severe.

5. I accept and assume such risks and responsibility for the losses and/or damages following such illness,  injury, disability, paralysis or death, however caused and whether caused in whole or in part by the negligence of the Releasees named below.

6. I HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE Charlottesville Brazilian Jiu Jitsu, LLC., including it owners, managers, or employees for all claims, demands, losses or damages and any claims or demands therefore on account of any injury, including but not limited to the death of the participant or damage to person or property, arising out of or relating to or alleged to be caused in whole or in part by the negligence of Charlottesville Brazilian Jiu Jitsu, LLC in the course of participating in any programming or activities conducted by or sponsored by Charlottesville Brazilian Jiu Jitsu, LLC.  I agree this release is binding on all of my/our personal representatives, assigns, executors, next friends, heirs and/or next of kin. 

7. I HEREBY acknowledge that THE ACTIVITIES OF THE EVENT(S) ARE VERY DANGEROUS and involve the risk of serious injury, illness and/or death and/or property damage. Each of THE UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES.

8. On behalf of the participant and individually, the undersigned partners(s) and/or legal guardian(s) for the minor participant executes this Waiver and Release. If, despite the release, the participant makes an unsuccessful claim against any of the Releasees, the parents(s) and/or legal guardian(s) will reimburse the Releasee for any money which they have paid in defending that claim, including costs, expert witness fees, and reasonable attorney’s fees.

9. I grant to Charlottesville Brazilian Jiu-Jitsu, LLC. its representatives and employees the right to take photographs of me and my property in connection with the above-identified subject. I authorize Charlottesville Brazilian Jiu-Jitsu, LLC., its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Charlottesville Brazilian Jiu-Jitsu, LLC. may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. If I feel I don’t want my picture used for these purposes I will make a verbal and written statement to Charlottesville Brazilian Jiu-Jitsu, LLC.

I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.