Participant Information

Participant Name: {{First Name}} {{Last Name}}
Date of Birth: {{DOB}}
Email: {{Email}}
Phone: {{Phone}}

If participant is under 18:
Parent / Legal Guardian Name: {{Guardian Name}}

1. ASSUMPTION OF RISK

I understand and acknowledge that participation in Brazilian Jiu-Jitsu, grappling, martial arts training, sparring, drilling, conditioning, self-defense training, open mat, seminars, and related activities involves inherent risks, including but not limited to:

• Cuts, bruises, abrasions

• Sprains, strains, and muscle injuries

• Joint injuries, dislocations, and fractures

• Neck, spine, and head injuries

• Loss of consciousness

• Permanent disability or death

I understand that these risks may result from my own actions or inactions, the actions or inactions of others, equipment or facility conditions, or the nature of the activity itself.

I voluntarily and knowingly assume all risks, whether known or unknown, foreseeable or unforeseeable.

2. PARTICIPANT RESPONSIBILITY

I represent and affirm that:

• I am physically capable of participating in training activities

• I have disclosed any medical conditions that could affect my participation

• I will follow all posted rules and instructor directions

• I understand Brazilian Jiu-Jitsu is a contact sport and accidental injury may occur even when safety protocols are followed

I accept full responsibility for my conduct and physical well-being while participating.

3. RELEASE & WAIVER OF LIABILITY (INDIANA)

To the fullest extent permitted under Indiana law, I hereby release, waive, discharge, and covenant not to sue:

Renagado BJJ, its owners, instructors, coaches, employees, independent contractors, volunteers, agents, landlords, and facility owners,

from any and all claims, demands, actions, causes of action, damages, or liabilities, whether known or unknown, arising out of or related to my participation, including claims based on negligence, except where prohibited by Indiana law.

4. INDEMNIFICATION

I agree to indemnify, defend, and hold harmless Renagado BJJ from any claims, damages, or costs (including attorney’s fees) arising from my participation or presence at the facility.

5. MEDICAL AUTHORIZATION

In the event of injury or medical emergency, I authorize Renagado BJJ staff to obtain emergency medical treatment on my behalf. I understand that Renagado BJJ assumes no responsibility for medical expenses incurred.

6. MINORS

If the participant is under 18 years of age, I certify that I am the parent or legal guardian and consent to the minor’s participation. I agree to all terms of this waiver on behalf of the minor and myself.

7. PHOTO & VIDEO RELEASE

I grant Renagado BJJ permission to use photographs or video recordings taken during training or events for promotional, educational, or marketing purposes, including website and social media, without compensation.

8. GOVERNING LAW & VENUE

This Agreement shall be governed by the laws of the State of Indiana.
Any legal action shall be brought exclusively in Porter County, Indiana.

If any portion of this Agreement is held invalid, the remaining provisions shall remain in full force and effect.

9. ELECTRONIC SIGNATURE

I understand that checking the box below and submitting this form constitutes my electronic signature, which is legally binding and equivalent to a handwritten signature under Indiana law.

☐ I HAVE READ AND AGREE TO THIS WAIVER

Electronic Signature (Full Legal Name): {{Signature}}
Date: {{Date}}