PINE TREE JIU JITSU
Participant Assumption of Risk, Release of Liability, Waiver of Claims & Indemnification Agreement
Use this document as a participant waiver. Have every adult participant and the parent/legal guardian of every minor sign before participating.
Participant Name: ________________________________
Date of Birth: ____________________
Phone: ____________________________
Email: ____________________________
Emergency Contact: ________________________________
Emergency Phone: _________________________________
1. Assumption of Risk
Brazilian Jiu Jitsu, grappling, wrestling, self-defense, fitness training, seminars, open mats, and related activities involve inherent risks including sprains, fractures, joint injuries, concussion, spinal injury, permanent disability, and death. I voluntarily assume all inherent risks associated with participation.
2. Voluntary Participation
I am participating voluntarily, will follow instructor directions, and may stop participation at any time.
3. Medical Fitness
I certify I am physically able to participate or have consulted a physician. I will inform instructors of any injury or medical concern.
4. Release of Liability
To the fullest extent permitted by Maine law, I release Pine Tree Jiu Jitsu, its owners, instructors, employees, volunteers, contractors, affiliates, and landlord from claims arising from participation, except where liability cannot legally be waived.
5. Personal Responsibility
I accept responsibility for my actions, will train safely, tap early, and immediately release submissions when a training partner taps.
6. Indemnification
I agree to indemnify and hold harmless Pine Tree Jiu Jitsu from claims arising from my participation to the extent permitted by law.
7. Personal Property
Pine Tree Jiu Jitsu is not responsible for lost, stolen, or damaged property.
8. Photo & Video Release (Optional)
☐ YES ☐ NO I authorize PTJJ to use photographs or video of me for promotional purposes without compensation.
9. Health & Hygiene
I will not train while contagious, with uncovered wounds, or under the influence of drugs or alcohol. I agree to maintain proper hygiene and clean training attire.
10. Emergency Care
If emergency treatment is reasonably necessary, I authorize PTJJ to obtain emergency medical care. I am responsible for resulting medical expenses.
11. Governing Law
This agreement is governed by the laws of the State of Maine.
12. Acknowledgment
I have read and understand this agreement, understand I am waiving certain legal rights, and sign voluntarily.
Signatures
Participant Signature: ________________________ Date: __________
Printed Name: ________________________________
Parent/Guardian (if under 18): __________________________
Parent/Guardian Signature: _____________________ Date: __________