New Student Information and Waivers

INTRO CLASS FORM
Student Name*
DOB*
Student’s Age*
Student Name
DOB
Student’s Age
Student Name
DOB
Student’s Age
Student Name
DOB
Student’s Age
Phone*
Email*
example@example.com
Occupation
Address*
ParentGuardian if under 18
Date of Trial

MonthDayYear
Date
How did you hear about Gracie Barra?

Internet SearchFriendFacebookInstagramOther
If you were referred by a friend please provide their name
What benefits do you expect to get from your BJJ Training?

Reduce StressFitnessDisciplineFocusRespectOther
Who else do you know that trains at Gracie Barra
GRACIE BARRA ELLIJAY

Waiver Release and Assumption of Risk

PLEASE READ CAREFULLY THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS

I understand that the martial art known as MMA, Jiu-Jitsu, Brazilian Jiu-jitsu, and/or Gracie Barra Jiu-Jitsu entails risk of accident or injury and that this risk may be in the form of an accident that may be serious or even mortal as a consequence of the practice of the before mentioned Jiu-jitsu.

I further understand that along with the possibility of personal injury that injury to property is also possible, such as, but not limited to, possible loss of wages and the ability to earn such, With full knowledge of the aforementioned dangers both to my person and to my property (current and future) and after having these dangers fully explained to me and/or to my legal guardian:

I hereby certify and declare that I will release and forever hold free and discharge from any liability, Gracie Barra Ellijay, Gracie Barra Jiu-Jitsu, their agents, employees and representatives of and from all claims, demands, rights and causes of action of any nature whatsoever which I may have or which may hereafter accrue to me, arising from and by reason of any and all bodily or personal injury, damage to property or other loss, and any consequences thereof, whether known or unknown, seen or unforeseen, resulting from my participation in MMA or Jiu-jitsu with the entities listed above.

Further, knowing and understanding these risks, nevertheless I hereby agree to voluntarily, assume these risks and to release and hold harmless all the persons or entities mentioned above who might otherwise be liable to me for damage. It is further understood that this waiver, release and assumption of risk is forever binding on my heirs and assigns.

My signature on this document is evidence that I know and understand and have had this document explained to me, that I fully understand the dangers inherent in this martial art and I voluntarily certify that I will not hold those mentioned above responsible for any injury whether the result of training or not.
SIGNATURES
Signature*

Clear
Date*

MonthDayYear
Date
Signature of Parent or Guardian

Clear
Date

MonthDayYear
Date
Printed Name of Parent or Guardian
PHOTO RELEASE FORM
I hereby agree and consent as follows:

A. I consent and authorize Gracie Barra Ellijay, located at 81 Ward Lane, Ellijay, GA 30540 to use my/my child's likeness in any photograph, video, or other digital media ("Photos") taken or to be taken while on the Gracie Barra Ellijay premises or taken during Gracie Barra events, in any and all of its publications, including print or web-based publications, and social media.

B. I irrevocably authorize Gracie Barra Ellijay to copy, edit, enhance, crop, or otherwise alter any Photo for use in their publications and/or on their social media accounts. I also waive any rights for approval or inspection of any Photos.

C. I understand and agree that all Photos are the property of Gracie Barra Ellijay, and will not be

D. I acknowledge that I am not entitled to any compensation or royalties with respect to the use of

E. I agree to release and forever discharge Gracie Barra Ellijay and its affiliates, successors, or assigns, officers, employees, representatives, partners, agents, and anyone claiming through them, in their individual and/or corporate capacities from any and all claims, liabilities, obligations, promises, agreements, disputes, demands, damages, causes of action of any nature or kind, known or unknown, which I, and anyone claiming on behalf of me, may have or claim to have against Releasee in connection with this Release.

F. I have carefully read and fully understand all the provisions of this Photo Release Form and am freely, knowingly, and voluntarily signing.
SIGNATURES
Signature of Releasor*

Clear
Date*

MonthDayYear
Date
Printed Name of Releasor*
Signature of Parent or Guardian

Clear
Date

MonthDayYear
Date
Printed Name of Parent or Guardian
Should be Empty:

INTRO CLASS FORM

SIGNATURES

PHOTO RELEASE FORM

SIGNATURES