CF Jiu Jitsu Waiver

Introductory Lesson Form

Welcome to Carlos Farias Jiu Jitsu Academy. It is an honor to share the mats and our Brazilian Jiu-Jitsu with you. You are about to experience a class designed for beginners. We are currently preparing a freshly clean uniform for you to use. Just follow the instructor’s lead and enjoy every second of it! Your BJJ journey starts now!
Trial ClassDrop-In (just visiting)
What is your home school name?*
YesNo
Parent/Guardian Name*

First NameLast Name
Person Trialing the Class Complete Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
What is your e-mail?*
example@example.com
What's your phone number?*
Please enter a valid phone number.Format: (000) 000-0000.
What's your address?*

Street Address

Street Address Line 2

CityState

Zip Code
YesNo
What's your occupation?
What kind of class are you trialing today?
Fundamentals GiAdvanced GiNo Gi
Tiny Grapplers (4 - 6 Years Old)Little Grapplers (7-9 Years Old)Juniors & Teens (10 to 15 Years Old)
MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Previous/Current Experience
NoYes. What kind of experience?
Any other current physical activities?
Why Brazilian Jiu-Jitsu?
FitnessDisciplineSelf-DefenseReduce StressRespectConcentrationCoordination/BalanceFun/EnjoymentAttitudeFocusOther
Referral
Internet SearchDrive/Walk byFriend that trains hereFamily MemberFacebookInstagramWazeYouTubeTVOther
What is their name?

First NameLast Name
General Release

Parent/Guardian Signature is required for minor participants under the age of 18.
I hereby acknowledge and understand that Brazilian Jiu-Jitsu is a physical activity and learning self-defense skills involves some physical contact. Carlos Farias Jiu Jitsu and/or its staff and students are not to be held liable or responsible for any risks and/or injuries as a result of training in Brazilian Jiu-Jitsu.
Selfie Time! (This picture is for identification purposes only, but give your best!)
Should be Empty:

Introductory Lesson Form

What kind of class are you trialing today?

Previous/Current Experience

Why Brazilian Jiu-Jitsu?

Referral

General Release