In this waiver, the term "Participant" refers to the individual engaged in martial arts activities provided by Gracie Jiu-Jitsu Alexandria. The "Signer" is defined as the individual who acknowledges and agrees to the terms of this waiver. For Participants under the age of 18, the Signer must be their legal guardian or parent. If the Participant is 18 years of age or older, they are required to be the Signer of this waiver themselves, thereby accepting all terms and conditions herein.
Your participation in any of the martial arts-related activities (hereinafter “Gracie Jiu-Jitsu” or the “Activities”) offered by or in connection with Gracie Jiu-Jitsu Alexandria is expressly conditioned upon your acceptance of the terms of this agreement. If, for any reason, you do not agree to the terms and conditions expressed herein, Signer should not sign this agreement, and Participant should not participate in any of the Activities.
PLEASE READ THE FOLLOWING CAREFULLY BEFORE DECIDING TO PARTICIPATE.
I understand that the martial art known as "Gracie Jiu-Jitsu" is taught using precautions to avoid any injuries. However, it may entail some risk of accident or injury and that this may be serious or even mortal as a consequence of the practice. Along with the possibility of personal injury, injury to property is also possible, including but not limited to, possible loss of wages and the ability to earn such wages.
The practice of Gracie Jiu-Jitsu presents a risk of skin infections, MRSA, transmittable diseases, bacteria(s) and viruses, including, but not limited to, COVID-19. Participant shall not attend Gracie Jiu-Jitsu classes if Participant is currently diagnosed with COVID-19 or if Participant has been in close contact with someone diagnosed with COVID-19 within the past 15 days. Further, if Participant is displaying symptoms of COVID-19, or if Participant is in close contact with someone who is displaying symptoms of COVID-19, Participant shall not attend Gracie Jiu-Jitsu classes. Symptoms of COVID-19 can range from mild illness to pneumonia, including fever, respiratory symptoms such as coughing, sore throat and/or shortness of breath, and other symptoms such as a runny nose, headache, muscle or joint pains, nausea, diarrhea, vomiting, loss of sense of smell, altered sense of taste, loss of appetite and fatigue. If Participant is displaying these symptoms when in attendance at Gracie Jiu-Jitsu classes, I acknowledge that Participant may be asked to leave.
I agree that Participant will not participate in the Activities unless Participant is medically able and properly trained, and I agree to abide by the decision of Gracie Jiu-Jitsu Alexandria official or agent, regarding Participant's approval to participate in the Activities.
PARTICIPANT IS VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITIES AND PARTICIPANT IS PARTICIPATING IN THE ACTIVITIES ENTIRELY AT THEIR OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH PARTICIPATING IN THESE ACTIVITIES, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO: PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, DISFIGUREMENT, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS’ NEGLIGENCE, CONDITIONS RELATED TO TRAVEL TO AND FROM THE ACTIVITIES, OR FROM CONDITIONS AT THE LOCATION(S) OF THE ACTIVITIES. NONETHELESS, PARTICIPANT ASSUMES ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME, OF PARTICIPANTS' PARTICIPATION IN THESE ACTIVITIES.
With full knowledge of the aforementioned dangers, both to participant's person and to participant's property (current and future), I hereby certify and declare that I will release and forever hold free and discharge from any liability Gracie Jiu-Jitsu Alexandria and each of their agents, stockholders, directors, officers, employees, independent contractors and representatives (collectively, “Gracie Jiu-Jitsu Alexandria”) from all claims, demands, rights and causes of action of any nature whatsoever which may have or which may hereafter accrue to me, arising from and by reason of any and all bodily or personal injury, damage to property or other loss and any consequence thereof, whether known or unknown, seen or unforeseen, resulting from participant's participation in, or my application of the techniques learned in Gracie Jiu-Jitsu, their persons and entities mentioned above.
Further, knowing and understanding these risks, I hereby agree to voluntarily assume these risks to Participant and to release and hold harmless all the persons or entities mentioned above whom might otherwise be liable to me for damages. It is further understood that this waiver, release and assumption of risk is forever binding on my heirs and assigns. I also understand and acknowledge that Participant has and will maintain appropriate medical insurance during classes/training.
I authorize any emergency first aid, CPR, AEDs, medication, medical treatment, and/or emergency transportation and I assume all costs involved in such treatment.
I understand that Gracie Jiu-Jitsu Alexandria reserves the right to refuse service to any individual who has been convicted of a sex crime.
I am also aware that for purposes of safety, security and quality control, there may be surveillance cameras mounted throughout the training facility. Furthermore, because of the popularity of Gracie University, I understand and acknowledge that video or photographs may be taken of Participant and any persons in attendance during classes/training. I hereby grant Gracie Jiu-Jitsu Alexandria and any of its assignees the unlimited use of Participant's likeness in any format (video, photo, or other) for promotional, advertisement or commercial use in perpetuity, and I forfeit any form of payment for such rights.
It is further understood that filming or photography of any classes/training at Gracie Jiu-Jitsu Alexandria by any person not employed by Gracie Jiu-Jitsu Alexandria is forbidden without prior permission.
I agree that if any term of this agreement is to any extent illegal, otherwise invalid, or incapable of being enforced, all other terms shall remain in full force and effect.
I understand that this agreement supersedes any and all previous oral or written agreements with regards to the practice of Gracie Jiu-jitsu and I give up substantial rights by signing it. My signature on this document is evidence that I know and understand what is written herein, that I fully understand the dangers that are inherent in the Activities, and that I voluntarily certify that I will not hold Gracie Jiu-Jitsu Alexandria, Gracie Global LLC, d.b.a. Gracie University, Rener Gracie, Ryron Gracie, the Gracie family, their agents, independent contractors, and/or instructors, responsible for any injury whether as a result of training or not. In addition, Participant agrees to follow the safety protocols presented to all students of {gym_name} at the time of registration and during the training.
I have read, understood, and agree to the terms and conditions outlined herein.
Participant Name: {name}Sign Date: {sign_date}
You are now on the waitlist. If a spot opens up we will notify you via Email.
I hereby agree and acknowledge:
a) I have been advised that the martial art know as "Gracie Jiu-Jitsu" is taught using precautions
to avoid injuries. However, participation in the Gracie Jiu-Jitsu classes carries with it certain
inherent risks and dangers that cannot be eliminated regardless of the care taken to avoid
injuries. The specific risks range from minor injuries such as scratches, bruises, and sprains, to
major injuries such as eye injury or loss of sight, joint or back injuries, heart attacks, and
concussions, to catastrophic injuries including paralysis and death.
b) The practice of Gracie Jiu-Jitsu presents a risk of skin infections, MRSA, transmittable
diseases, bacteria(s) and viruses, including, but not limited to, COVID-19.
c) I shall not attend Gracie Jiu-Jitsu classes if I am diagnosed with COVID-19 or it I am in close
contact with someone diagnosed with COVID-19. Further, if I am displaying symptoms of COVID-
19, or if I am in close contact with someone who is displaying symptoms of COVID-19, I shall not
attend Gracie Jiu-Jitsu classes. Symptoms of COVID-19 can range from mild illness to
pneumonia, including fever, respiratory symptoms such as coughing, sore throat and/or
shortness of breath, and other symptoms such as runny nose, headache, muscle or joint pains,
nausea, diarrhea, vomiting, loss of sense of smell, altered sense of taste, loss of appetite and
fatigue. If I am displaying these symptoms when in attendance at Gracie Jiu-Jitsu classes I
acknowledge that I may be asked to leave.
d) Along with the possibility of personal injury, injury to property is also possible, including but
not limited to, possible loss of wages and the ability to earn such wages.
e) I acknowledge that I have consulted with a physician and I have no health problems that would
preclude me from full and safe participation in Gracie Jiu-Jitsu.
f) With full knowledge and understanding of the aforementioned risks, both to myself and to my
property, and after having these dangers fully explained to myself and/or to my legal guardian:
_________________________ (Name of Legal Guardian if Under 18, please enter name below), I
nevertheless desire to participate in Gracie Jiu-Jitsu training activities.
g) Due to the nature of the activities conducted in Gracie Jiu-Jitsu classes, it would be
unreasonable for Gracie Global, LLC (d.b.a. Gracie University), Leisal LLC (d.b.a. Gracie Jiu-Jitsu
Alexandria) Virginia Dojo, LLC and/or the respective owners, directors and shareholders, agents
and employees to be in any way responsible for my injury (or death) and to the full extent of the
law I hereby waive my legal rights of action against and fully release the company of loss,
damages, injury or death however arising out of or in relation to my participation in the activitiesconducted or organized by the company including, without limitation, liability for any negligent
or tortious act or omission, breach of duty, breach of contract or breach of statutory duty on the
part of the company, its office bearers, directors, employees or agents.
h) I have and will maintain appropriate medical insurance during classes/training. I authorize any
emergency first aid, CPR, AEDs, medication, medical treatment, and/or emergency
transportation and I assume all costs involved in such treatment.
i) I understand that Gracie University, Gracie Jiu-Jitsu Alexandria, Virginia Dojo, reserves the right
to refuse service to any individual who has been convicted of a sex crime.
j) I will not video record or photograph any classes/training without prior permission from Gracie
University, Gracie Jiu-Jitsu Alexandria, and/or Virginia Dojo.
k) I am also aware that for purposes of safety, security and quality control there are surveillance
cameras mounted throughout Gracie University, Gracie Jiu-Jitsu Alexandria and Virginia Dojo.
Furthermore, I understand and acknowledge that video recordings or photographs may be taken
of me during classes/training. I hereby grand Gracie Global, LLC (d.b.a. Gracie University), Leisal,
LLC (d.b.a. Gracie Jiu-Jitsu Alexandria), Virginia Dojo, LLC the unlimited use of my likeness in any
format - photo, video, or other promotional advertisement or commercial use in any format know
or yet to be developed in perpetuity, and I forfeit any form of payment.
l) I agree that if any term of this agreement is to any extent illegal, otherwise invalid, or incapable
of being enforced, all other terms shall remain in full force and effect. I understand that this
agreement supersedes any and all previous oral or written agreements with regards to the
practice of Gracie Jiu-Jitsu and I give up substantial rights by signing it.