Kaizen BJJ - Enrolment Form

Kaizen BJJ - Enrolment Form
Kaizen Brazilian Jiu-Jitsu is a new academy based in Wellington UK, with a new method in teaching and training for competition formed by friendship and love of the sport. We are fuelled by passion for improving ourselves and reaching the 99% percent of perfection and always hunting the extra 1%.

We’re part of the Pedro Bessa / 99 Brazlian Jiu-jistu family.

We hold regular evening classes along with weekend classes. Our timetable is available on our website. We also have a Whatsapp group for adult members and a Whatsapp group for parents/guaridans of children members.

First session is free for all new students

Adult class payment is either pay as you go £6 per session or £35 per month.

Child class payment is £5 per session and 1/2 price for 2nd and 3rd siblings.

Payment can be card or cash at the gym. Direct debits can be set up, please ask for more information.

Dress code - we do not require members to wear specific affiliated GIs or no GI apparel.

New students - If you do not have a GI or NO GI clothing, please wear comfy sports clothing (e.g tshirt and shorts, no jeans) and adhear to the Code of Contact as per below.

Personal Details
Name of Student*

First NameLast Name
Telephone*
If the student is under 18, please provide parent/guardian details
Email*
If the student is under 18, please provide parent/guardian details
Date of Birth of student*

DayMonthYear
Does the student have any existing medical conditions?*
If you answered YES on medical conditions question, please provide more details
Does the student take any medication we should know about*
If you answered YES on medication question, please provide more details
Emergency Contact (or Parent/Guardian details - if filling out form for student under 18) *

First NameLast Name
Relationship to student*
Telephone*

Code of Conduct
• Always be respectful of others
• All students must wear a clean suitable attire for classes
• Always wear footwear when you are off the mat
• All jewellery should be removed before training and long hair tied back
• Keep fingernails/toenails neatly trimmed
• Shoes and food are not allowed on the mats
• If you have a skin irritation or injury, check with the instructor before class
• Follow the instruction of the instructors at all times
• Use the proper safety equipment such as mouthguard
• Report any injuries to the instructor immediately

Risk Assessment

Waiver
I certify I am at least 18 years of age. If student is under 18 the parent/guardian is the below signed and has agreed to the following waiver on the students behalf.

I understand that classes at may be physically strenuous, and I voluntarily participate in them with full knowledge that there is risk of personal injury, property loss or death. I am aware of the inherent risks of Brazilian Jiu-Jitsu, including but not limited to:
- Bruises
- Scrapes
- Cuts
- Joint injuries
- Muscle Strains
- Headaches
- Concussions
- Broken Bones
- Death
I understand that these risks may be caused by my own actions or the actions of others, and I agree to assume all responsibility for any injuries that I may sustain while participating in BJJ classes.

I understand that I am participating in a sport that has physical contact. I assume full responsibility for all of my actions during and connected to my training at the Kaizen BJJ. I understand the risk of taking part in this type of sport. Therefore, I hereby release, waive, discharge, Kaizen BJJ and all persons associated with Kaizen BJJ, including but not limited to, it's owners, employees and volunteers, from any and all liability claims demands actions, causes of action whatsoever arising out of or related to a loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, while participating in physical activity, or while on or upon the premises where the activity or contact is being conducted.

I, the undersigned also state that to the best of my knowledge, I am in good health and physical condition and know of no reason why I cannot participate in this training. I hereby further represent that I have no medical or other condition, that would expose myself or others at Kaizen BJJ, to any type of risk whilst participating in classes, instruction, or use of the facilities at Kaizen BJJ.

I agree that Kaizen BJJ is in no way responsible for the safekeeping of my personal belongings while I attend class.

I agree to always adhere to the Kaizen BJJ code of conduct.

In case of emergency, I hereby authorise any licensed medical personnel to perform any accepted medical procedure deemed necessary and I agree to bear any potential expenses of any such treatment. I also agree that my attendance and/or performance at training may be photographed, filmed, or taped and used for marketing purposes by any schools and I waive any compensation thereof.

This waiver is effective for the duration of my enrolment in BJJ classes at Kaizen BJJ. I understand I may revoke this waiver at any time by providing written notice to Kaizen BJJ

I, the undersigned, have read the release above and agree to all of its terms.
Signature*

Clear
Name of signatory *

First NameLast Name
Signed by*

StudentParent/guardian on behalf of student under 18
Date

DayMonthYear
Should be Empty: