Fortitude BJJ Stowmarket 7 Day Free trial
Please fill out the below details and we'll get you booked in and on the mats in no time. Any questions give Gary a call/Whatsapp on 01473875135
Fortitude BJJ – Membership Waiver & Health Declaration
Brazilian Jiu-Jitsu involves physical contact and carries inherent risks. All members must complete this waiver before participating in training at Fortitude BJJ Stowmarket.
Name
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First Name
Last Name
Date of Birth
*
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Day
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Month
Year
Date
Phone Number
*
-
Area Code
Phone Number
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Emergency contact details
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Relationship to paticipant
*
Is the participant under 18?
*
Yes
No
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Medical & Health Information
Do you have any current injuries?
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Yes (Please explain below)
No
Describe Injury
Have you had any major injuries or surgeries?
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Yes (Please explain below)
No
Please explain injury or surgeries
Do you have any medical conditions instructors should know about? Examples: asthma, epilepsy, heart conditions, diabetes
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Yes (Please explain below)
No
Add details below
Are you currently taking any medication?
*
Yes (Please explain below)
No
Add details below
Do you have any allergies?
*
Yes (please explain below)
No
Add details below
Terms & Conditions
I understand that Brazilian Jiu-Jitsu, grappling and martial arts training involve physical contact and carry inherent risks including but not limited to sprains, strains, joint injuries, broken bones, concussion, cuts and bruises.I voluntarily choose to participate in training at Fortitude BJJ and accept these risks.I agree to follow the instructions of coaches and staff and to train responsibly.I confirm that the medical information provided is accurate to the best of my knowledge.To the fullest extent permitted by UK law, I agree that Fortitude BJJ, its instructors and staff shall not be held liable for injuries sustained during participation except where caused by negligence.
Do you agree to our terms and conditions
*
Yes
No
Photo Consent
*
I consent to photos/videos being used for Fortitude BJJ marketing
I do not consent
Participant signature (18+)
*
Date
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Month
-
Day
Year
Date
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Parent / Guardian Consent (Required for Under 18s)
Parent/guardian name
First Name
Last Name
Phone Number
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Area Code
Phone Number
Parent/guardian signature
Date
-
Day
-
Month
Year
Date
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