Signup

Roughstock Jiu Jitsu LLC Waiver, Release of Liability, Assumption
of Risk and Agreement to Participate form
This agreement must be signed by any and all members who wish to
participate in any class, event, and/or activities hosted by
Roughstock Jiu Jitsu LLC
I hereby acknowledge that my participation in
martial arts activities at Roughstock Jiu Jitsu LLC involves inherent risks,
including but not limited to physical injury, permanent disability or even death,
and severe social and economic loss.
In consideration for being allowed to participate, I release Roughstock Jiu Jitsu LLC, their agents,
employees, and affiliated entities from any and all liability for injuries, damages, or losses that may
occur as a result of my participation.
-I agree to abide by all rules and guidelines set forth by Roughstock Jiu Jitsu LLC and its instructors.
-I understand the importance of following safety instructions and will notify the instructor of any physical
conditions or limitations that may affect my ability to participate safely.
-I affirm that I am in good physical condition and have no medical conditions that would prevent my
participation.
-I grant permission for any necessary emergency medical treatment in the event of injury.
-I agree to inspect the facilities, equipment, and pairings prior to participation. I will immediately inform
the instructor if I believe that anything is unsafe or beyond my capability and refuse to participate.
-I release, waive, discharge, and covenant not to sue, Roughstock Jiu Jitsu LLC, its affiliated
organizations and governing bodies, their instructors and personnel, other members of the
organizations, participants, supervisors, coaches, sponsoring organizations or their agents, and if
applicable, owners and leasers of the premises from any and all liability to the undersigned, his or her
heirs and next of kin for any and all claims, demands, losses and damages which may be sustained
and suffered on account of injury, including death or damage to property, caused or alleged to be
caused in whole or in part by the negligence of the releases or otherwise.
-I grant permission to Roughstock Jiu JItsu LLC, its agents and employees to take and use
photographs taken of me and/or my minor child/children during classes, events and or activities for use
on websites or social media, newsletters, brochures.
-I hereby waive any right to inspect or approve the finished photographs or printed or electronic matter
that may be used in conjunction with them now or near future and waive any right to royalties or other
compensation arising from or related to the use of the photograph.
I have read and understand this waiver and release of liability, and I sign it voluntarily without any
inducement.