HOUSE OF KINGS JIU JITSU

SUMMER CAMP LIABILITY WAIVER & EMERGENCY INFORMATION

Participant Name: {name}

Date of Birth: {dob}

Phone: {phone}

Parent/Guardian Name: ______________________________

Home Address: ______________________________

Emergency Contact Name: {contact_name}

Relationship: {contact_relation}

Emergency Phone: {contact_phone}

1. Assumption of Risk

I understand that participation in Brazilian Jiu Jitsu, martial arts, kickboxing, fitness training, strength and conditioning, games, outdoor activities, and all other House of Kings Summer Camp activities involves inherent risks, including but not limited to:

• Sprains, strains, and muscle injuries

• Broken bones and joint injuries

• Concussions or head injuries

• Cuts, bruises, and abrasions

• Heat-related illness

• Accidental falls

• Serious bodily injury, paralysis, or death

I voluntarily assume all risks associated with participation in these activities.

2. Release and Waiver of Liability

In consideration of being allowed to participate in House of Kings Jiu Jitsu Summer Camp activities, I release, waive, discharge, and covenant not to sue House of Kings Jiu Jitsu, its owners, coaches, instructors, employees, volunteers, representatives, and agents from any and all liability, claims, demands, actions, or causes of action arising out of or related to any injury, illness, loss, damage, or death that may occur while participating in camp activities or while on the premises.

This release applies even if the injury is caused by negligence, except where prohibited by law due to gross negligence or intentional misconduct.

3. Medical Authorization

I certify that each participant listed is physically able to participate in Summer Camp activities or that any medical conditions have been disclosed above.

In the event of injury or medical emergency, I authorize House of Kings Jiu Jitsu to obtain emergency medical treatment for my child(ren) if I cannot be reached.

I agree to be financially responsible for any medical treatment received.

4. Rules & Conduct

I agree that each participant will:

• Follow all instructor directions and gym rules.

• Treat coaches, staff, and fellow campers with respect.

• Use equipment safely and properly.

• Maintain appropriate hygiene for close-contact activities.

• Display good sportsmanship at all times.

House of Kings Jiu Jitsu reserves the right to remove any participant from camp for unsafe, disruptive, or inappropriate behavior. Removal from camp for disciplinary reasons may occur without refund.

5. Illness Policy

Participants should not attend camp if they have:

• A fever

• Vomiting or diarrhea within the previous 24 hours

• A contagious illness

• Ringworm or other contagious skin infections

• Any condition that could place other campers at risk

6. Photo & Video Release

I grant permission for House of Kings Jiu Jitsu to use photographs or video recordings of participants taken during Summer Camp for promotional purposes, including social media, the website, and other marketing materials.

7. Personal Property

House of Kings Jiu Jitsu is not responsible for lost, stolen, or damaged personal belongings brought to camp.

8. Communicable Disease Acknowledgment

I understand that participation in close-contact sports and group activities may increase exposure to communicable illnesses. I voluntarily assume this risk.

9. Severability

If any provision of this agreement is found to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.

10. Multiple Participant Acknowledgment

I acknowledge that I may be registering one or more children under this single Summer Camp registration and waiver. By signing this agreement, I represent that I am the parent or legal guardian of each child listed on this registration form and have the legal authority to execute this waiver on their behalf.

I understand and agree that this Liability Waiver, Assumption of Risk Agreement, Medical Authorization, and all other terms contained herein apply equally to every child listed on this registration form. I further acknowledge that I am signing this agreement on behalf of each listed participant and that no separate waiver is required unless requested by House of Kings Jiu Jitsu.

11. Acknowledgment of Understanding

I have carefully read this agreement in its entirety. I fully understand its terms and understand that by signing this document I am giving up certain legal rights. I sign this agreement freely and voluntarily on behalf of myself and, if applicable, each minor participant listed on this registration.

Participant/Parent/Guardian Signature:

Printed Name: {name}

Date: {sign_date}