Parent / Guardian Information

Student Information

Emergency Contact Information

I, the parent or the legal guardian (my name above this form) entirely upon my own initiative and risk and responsibility am about to participate in Brazilian Jiu-Jitsu training at Over Limit Jiu Jitsu Academy. I am at least 18 years of age. If I am under 18 years of age, a parent or guardian will sign below on my behalf. I understand that Brazilian Jiu-Jitsu can cause serious injury or even death. I will be learning to immobilize an opponent by choking them unconscious or causing major trauma to joints such as the shoulder, knee, or elbow. At some point everyone who trains in Brazilian Jiu-Jitsu long enough will suffer at least a minor injury. Knowing all of the above, I freely choose to participate in class and acknowledge my risk. Therefore, I do hereby for myself, my heirs, executors, and administrators release and hold harmless to Over Limit Jiu Jitsu Academy, and the instructors from any and all liability, negligence, claims demands, actions or causes of actions, or caused of actions resulting from any participation in this sport/activity/class and associated activity.