Welcome to ENZO BJJ. This registration will allow you to provide contact information . Please read through each page carefully to ensure that all information is provided accurately. We will need this form signed and submitted before you can start training.
ENZO BJJ Adult Enrollment Form
First Name
*
Last Name
*
Gender
male
female
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Other
Country
Birth Date
*
month/day/year
Age
*
# of Years Jiujitsu experience
*
Training Goals
Fitness/Weight loss
Self-defense
Competition/Mastery
Self Confidence
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Waiver - Release of Liability
I am aware that Brazillian Jiujitsu is an aggressive, physical sport involving severe cardiovascular stress and violent physical contact. I understand that Brazillian Jiujitsu involves certain risks, including but not limited to death, serious neck and spinal injuries resulting in complete or partial paralysis, brain damage, and serious injury to virtually all bones, joints, muscles, and internal organs, mouth, eyes, teeth, ears and throat. In addition, I understand that participation in Brazillian Jiujitsu involves activities incidental thereto, including but not limited to the possible reckless conduct of other participants. I am voluntarily participating in this activity with knowledge of the danger involved and hereby agree to accept any and all inherent risks of property damage, personal injury, or death.
Also, in consideration of my participation in Brazillian Jiujitsu, I hereby release, hold harmless and covenant not to sue ENZO BJJ its representatives, its venue providers, and any of its sponsors, lessors, volunteers, referees, employees, instructors, coaches or agents (hereinafter collectively “ENZO BJJ”), from any and all present and future claims for property damage, personal injury, or wrongful death arising as a result of my participation in the Tournament and associated activities, wherever, whenever, or however the same may occur. I hereby voluntarily waive any and all such claims, both present and future, that may be made by me, my family, estate, heirs, or assigns. I further agree to defend and indemnify ENZO BJJ should any claims be asserted against ENZO BJJ by third parties because of my claims for property damage, personal injury, or wrongful death.
I understand that this waiver is intended to be as broad and inclusive as permitted by the laws of the State of Texas and agree that if any portion is held invalid, the remainder of the waiver will continue in full legal force and effect. I further affirm that the venue for any legal proceedings shall be in the State of Texas. I affirm that I am of legal age, or that as a minor I am having a legally recognized parent or guardian execute and I/we are freely signing this agreement. I have read this form and fully understand that by signing this form, I am giving up legal rights and/or remedies which may be available to me for claims against ENZO BJJ or any of the parties listed above.
Terms and Conditions Acceptance
*
I/We Hereby Accept the Terms and Conditions above.
Signature
*
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Medical Information
Emergency Contact Name:
*
Emergency Contact Primary Phone Number:
*
-
Area Code
Phone Number
Emergency Contact 2 Name:
Emergency Contact 2 Primary Phone Number:
-
Area Code
Phone Number
Does the participant have any allergies, present medication, special considerations, etc.:
*
Yes
No
If Yes, Please Explain:
Date
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Month
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Day
Year
Date
Submit enrollent form
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