HOUSE OF KINGS JIU JITSU
LIABILITY WAIVER & ASSUMPTION OF RISK AGREEMENT
Participant Name: _______{name}_________________________
Date of Birth: _____{dob}_______________
Phone: _______{phone}_____________
Email: __________{email}__________________
Emergency Contact Name & Phone: {contact_name} {contact_phone} {contact_relation}
1. Acknowledgment of Risk
I understand that participation in Brazilian Jiu Jitsu, kickboxing, martial arts training, fitness training, strength training, and related activities at House of Kings Jiu Jitsu involves inherent risks, including but not limited to:
Sprains, strains, and muscle injuries
Broken bones and joint injuries
Concussions or head injuries
Cuts, bruises, or abrasions
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 activities at House of Kings Jiu Jitsu, I hereby 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 loss, damage, or injury, including death, that may be sustained by me while participating in gym activities or while on the premises.
This release applies even if the injury is caused by negligence (but not gross negligence or intentional misconduct, where prohibited by law).
3. Medical Authorization
I certify that I am physically fit to participate and have no medical condition that would prevent safe participation. I understand it is my responsibility to consult a physician before engaging in physical activity.
In the event of injury or medical emergency, I authorize House of Kings Jiu Jitsu to obtain emergency medical treatment on my behalf.
I agree to be financially responsible for any medical treatment received.
4. Rules & Conduct
I agree to:
Follow all gym rules and instructor directions
Use equipment properly
Treat staff and members with respect
Maintain personal hygiene appropriate for close-contact training
Failure to follow rules may result in removal from participation without refund.
5. Photo & Video Release
I grant permission for House of Kings Jiu Jitsu to use photographs or video recordings of me taken during training for promotional purposes, including social media, website, and marketing materials.
6. COVID / Communicable Disease Acknowledgment
I understand that participation in close-contact sports may increase exposure to communicable illnesses. I voluntarily assume this risk.
7. Minor Participants (If Under 18)
If the participant is under 18, a parent or legal guardian must sign below.
I certify that I am the parent or legal guardian of the above-named minor and agree to all terms of this waiver on their behalf.
8. Severability
If any portion of this agreement is found to be unenforceable, the remaining portions shall remain in full force and effect.
9. Acknowledgment of Understanding
I have read this agreement carefully. I fully understand its terms and understand that I am giving up substantial legal rights by signing it. I sign it freely and voluntarily.
Participant Signature: __________________________________
Date: ______{sign_date}____________
Printed Name: __________{name}_____________________________
If Minor:
Parent/Guardian Signature: _____________________________
Date: _______{sign_date}_______________
Printed Name: ______{name}________________________________
House of Kings Jiujitsu
