Waiver Release Form – Minor - KAOS Dojo | Brazilian Jiu Jitsu Launceston

Name 🥋 *

First

Last

Address 🏠 *

Parent/Guardian *

Parent/Guardian Phone 📞 *

Parent/Guardian Email 📧 *

Does the minor have any pre-existing medical conditions that may impact their training? *

Previous experience with martial arts training 🤼 *

New
1-5 yrs
5+ yrs

Do you give permission to use their image for marketing purposes? 📢 *

Yes
No

How did you hear about us? 👂 *

Social media
Website/online
Word of mouth
Other

Terms and conditions *

Click here to agree once you have read below

*Please read carefully. This document affects your legal rights. Waiver release and assumption of risk

I hereby agree to participate in the required physical activities and exercises as required for certification within the Brazilian Jiu Jitsu courses conducted by KAOS Dojo Incorporated on the basis of the terms and conditions set out below:

1. I hereby acknowledge an understanding of and agree to participate in physical demanding activities that if done incorrectly could be detrimental to my health.

2. I acknowledge that the training, while conducted in the safest possible conditions and under qualified supervision, involves physical contact and inherent risks and I accept those risks. I agree to conduct myself in a safe and mature manner in accordance with the instructions from my instructors.

3. I indemnify KAOS Dojo Incorporated, its proprietors, agents and officers, including all instructors, staff members, and students against any loss or damage suffered by them in connection with my participation in the training. I realize that serious injury in marital arts such as these are quite likely and that even death is a possibility. I also realize that if I am injured, I might be disfigured, disabled or rendered unable to work again.

4. I confirm I am physically capable of participating in this training and that I have no existing medical condition which precludes or should reasonably preclude my participation.

5. I authorize whatever medical personnel, that may be present at KAOS Dojo Incorporated to take any action deemed necessary, should I become injured. I represent that I am in good health; that I am not presently, nor will I participate while under the influence of any illicit drug medication; that no one affiliated with KAOS Dojo Incorporated has adversely encouraged me to train or made any representations regarding my fitness or ability to participate.

6. I agree to release KAOS Dojo Incorporated, its proprietors, agents and officers, including all instructors, staff members, and students from any liability whatsoever in connection with my participation in the required physical activities and exercises within the Brazilian Jiu Jitsu training programs. Without limitation, this includes all loss or damage or injury incurred as a direct or indirect result of my participation.