Drop Bear Club Participation Registration Form

Person Entering Information in this Form (18+yrs only)*

First NameLast Name

Which facility location will you be mainly training at?*

Student 1 Name*

First NameLast Name

Student 2 Name

First NameLast Name

Student 3 Name

First NameLast Name

Student 4 Name

First NameLast Name

Student 5 Name

First NameLast Name

Student 1 Birth Date (ages 4+)*

YearMonthDay

Student 2 Birth Date (ages 4+)

YearMonthDay

Student 3 Birth Date (ages 4+)

YearMonthDay

Student 4 Birth Date (ages 4+)

YearMonthDay

Student 5 Birth Date (ages 4+)

YearMonthDay

Parent or Legal Guardian (if under 18 yrs)

First NameLast Name

Phone Number:*

Area Code Eg. "04" for mobilesPhone Number

Emergency Contact*

First NameLast Name

Emergency Contact Phone Number*

Area Code Eg. "04" for mobilesPhone Number

E-mail (for club communication and invoicing)*

Address:*

Street Address

Street Address Line 2

City

Zip Code

Have you taken Martial Arts classes before?

YesNo

If so, what style and for how long?

Do you have any medical history or conditions that could affect your ability to participate in contact sports? *

NoYes (Please enter details)

Medical Conditions (Please state Student Name and details of condition/s)

Where did you hear about us?

Terms:

Drop Bear Brazilian Jiu-Jitsu does NOT require members to sign a lock in contract for an extended period of time. However, a minimum 14 days of notice must be given to cancel or freeze memberships. Memberships may be frozen for a minimum of 4 weeks, however, the membership deductions will then default to the latest fee schedule on re-commencement. Freezing memberships does not guarantee training spots will be available on re-commencement. Registered account holders may freeze their memberships or cancel by written notification via email to dropbearbjj@gmail.com, or a message to Facebook or Instagram Messenger. The first week of class participation is FREE with no obligation. If training is continued after the first week the registered account holder will be subject to the relevant or agreed upon membership rate deductions. While every attempt will be made to keep costs low, training fees may be subject to change over time due to inflationary factors. Drop Bear Brazilian Jiu-Jitsu is a community focused entity and relies on the prompt payments of members to stay open. Upon joining, a Direct Debit Pre-Approval will be emailed. Upon completion of this, a weekly invoice will be sent via email. By enrolling in direct debit payments, registered account holders acknowledge that they have read, understood, and agreed to comply with the terms outlined in this policy.

Declaration:

I agree to pay the membership dues in line with the above Terms. I recognise that it is a condition of weekly memberships for my payment card details to be encrypted and stored by Pinch Payments. If I am unable to make a payment I will notify a club manager immediately to discuss options. I understand that I am obligated to pay the agreed membership fees even if classes are not attended that week. I accept payments will not be refunded retrospectively. I acknowledge that the club will be closed for around 2 weeks over the Christmas period. I accept that the fees have been calculated to include these shut down periods.

Acknowledgment*

I have read and understand the payment policy

MEMBERSHIP RULES

Children are not permitted to roam unsupervised outside the academy space.

Parents/guardians to supervise children under 10 years to the bathroom and ensure toilet facilities are clean after use.

No food or chewing of gum are allowed inside the building.

Show your instructor respect by paying attention.

Report all injuries to the instructor immediately.

When arriving at class with an injury, the instructor must be notified prior to the start of class.

Shoes are NEVER to be worn on the mat and will ALWAYS be worn off the mat.

Water bottles are permitted in designated area at mat-side.

Never come to class under the influence of drugs or alcohol.

Members are to arrive at training in a clean and hygienic condition - adults please use anti-perspirant deodrant.

Members are to laundry their gis/training gear (including belts) after EVERY training session.

Finger and toenails are to be kept clean and trimmed to a reasonable length to prevent injuries to training partners.

No jewelry may be worn during class unless specifically approved by the instructor.

Members without uniforms should not have anything in their pockets.

Martial Arts may involve pulling on the clothing, and whatever you wear could become torn.

Spills are to be cleaned immediately.

Rubbish should be placed in the proper container.

Water bottles to be emptied and lids removed prior to putting in the recycling bin.

Show respect to your training partners.

Acknowledgment*

I have read, understood, and accepted the rules for membership.

Photos and Videos*

I understand that occasionally, photos and videos from club competitions and practices will be used in promotional material for the club. I agree to allow my image or my child's image to be used for this purpose and that I will not be compensated. I also understand that once a promotional item has been produced, it is not possible to remove my image or my child's image from the production.

Information Privacy*

I understand that the club will never share my contact information for commercial purposes. I may, however, be contacted by the club managers about club announcements and information relevant to club membership.

Recognise and understand that martial arts training is a physical contact activity and that my participation might result in serious injury, including permanent disability or death, and severe social and economic loss. Recognise and understand that such risk may be due to not only my own actions, but also the action, inaction or negligence of others. Recognise that there may be other risks that are not known to me or to others or not reasonably foreseeable at this time. Agree to inspect the facilities, equipment and pairings prior to participation. I will immediately inform an instructor if I believe that anything is unsafe or beyond my capability and refuse to participate. Assume all of the foregoing risks and accept personal responsibility for any damages that may result from injury, permanent disability or death. Enter martial arts training and/or competition entirely of my own free will and understand the importance of following the rules of training and competition. I certify that I (or my child) am in good physical condition, and have no illness or condition that may risk the health of my training partners. If I or my child have any injuries or illnesses that could affect my ability to participate, I will notify the club managers and coaches, and discuss the appropriateness of martial arts training with my or my child's doctor. Grant permission in case of injury to have a doctor, nurse, athletic training or other emergency medical personnel provide me or my child with medical assistance or treatment for such injury. The cost of any treatment or hospitalisation arising from injury during training or play shall not under any circumstance be paid by Drop Bear Brazilian Jiu-Jitsu, its affiliated organisations and governing bodies, their officers, instructors and personnel, other members of the organisations, participants, supervisors, coaches, sponsoring organisations or their agents. Release, waive, discharge and covenant not to take legal action against Drop Bear Brazilian Jiu-Jitsu, its affiliated organizations and governing bodies, their officers, instructors and personnel, other members of the organisations, participants, supervisors, coaches, sponsoring organisations or their agents, and if applicable, owners and leasors 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 realeasees or otherwise.

Acknowledgment*

I have read, understood, and accept the disclaimer and liability waiver and sign it of my own free will

Signature of Member or Legal Guardian*

Drop Bear BJJ Participation Form

Payment Policy

Membership Rules

Privacy Policy

Disclaimer and Waiver of Liability