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PLEASE READ AND SIGN OUR RELEASE OF LIABILITY AGREEMENT BELOW:

1. RELEASE OF LIABILITY

1. STUDENT ACKNOWLEDGES THAT PARTICIPATION IN MARTIAL ARTS INSTRUCTIONAL CLASSES AND ACTIVITIES INVOLVES INTENSE, STRESSFUL AND STRENUOUS EXERCISE AND PHYSICAL CONTACT, WHICH CARRY WITH THEM A HIGH DEGREE OF RISK AND CAN RESULT IN SERIOUS PHYSICAL OR EMOTIONAL INJURY, INCLUDING, BUT NOT LIMITED TO PARALYSIS, DEATH, BRUISES, BLOODY NOSES, UNCONSCIOUSNESS, SOFT TISSUE DAMAGE, BROKEN BONES, HEART ATTACKS, AND OTHER CARDIOVASCULAR INJURY, AND OTHER SERIOUS DAMAGE TO PERSON OR PROPERTY. STUDENT FURTHER ACKNOWLEDGES THAT SUCH RISKS CANNOT BE ELIMINATED WITHOUT JEOPARDIZING THE ESSENTIAL QUALITIES OF THE ACTIVITY.
2. STUDENT CONFIRMS THAT STUDENT HAS BEEN MADE AWARE OF THE ABOVE RISKS AS WELL AS OTHER RISKS ASSOCIATED WITH PARTICIPATING IN MARTIAL ARTS INSTRUCTION AND THE MARTIAL ARTS, AND THAT STUDENT IS HEREBY ASSUMING SUCH RISKS VOLUNTARILY.
3. STUDENT HEREBY RELEASES AND AGREES TO INDEMNIFY AND HOLD THE ACADEMY LOS ANGELES JIU-JITSU AND ITS OFFICERS, DIRECTORS, MANAGERS, MEMBERS, PARTNERS, EMPLOYEES AND AGENTS AND THEIR RESPECTIVE AFFILIATES HARMLESS FROM ANY AND ALL CLAIMS AND LIABILITIES OF ANY KIND OR NATURE ARISING OUT OF, OR RELATED TO, STUDENT’S PARTICIPATION IN THE ACADEMY’S CLASSES AND CURRICULUM AND THE MARTIAL ARTS, INCLUDING, BUT NOT LIMITED TO, ANY CLAIMS BASED ON THE ACADEMY’S NEGLIGENCE.
4. STUDENT CERTIFIES THAT STUDENT HAS AT ALL TIMES DURING THE TERM WILL HAVE ADEQUATE INSURANCE TO COVER ANY INJURY OR DAMAGE SUFFERED AS A RESULT OF ATTENDING ACADEMY CLASSES OR PARTICIPATING IN THE MARTIAL ARTS. ALTERNATIVELY, STUDENT CERTIFIES THAT STUDENT HAS, AND DURING
   THE TERM WILL CONTINUE TO HAVE, THE MEANS TO SELF INSURE AGAINST SUCH INJURY OR DAMAGE. STUDENT FURTHER CERTIFIES THAT STUDENT HAS NO MEDICAL CONDITION WHICH COULD INTERFERE WITH STUDENT’S SAFE PARTICIPATION IN ACADEMY CLASSES OR THE MARTIAL ARTS.

Student's Name: {name}                                              Date of Birth: {dob}

Guardian / Emergency contact: {contact_name} Relation: {contact_relation} Phone: {phone}

The Los Angeles Jiu-Jitsu Academy (the Academy, LAJJAcademy, LA Jiu-Jitsu Academy) encourages and requests all Members and guests who use or visit the Academy’s facilities to follow the most current guidelines issued by the Centers for Disease Control and Prevention (CDC) for best practices to avoid influenza and respiratory illnesses such as COVID-19, as well as federal, state and local requirements. The CDC’s COVID-19 homepage, with links to guidelines, can be found here http://www.cdc.gov/coronavirus/2019-nCoV/index.html. Generally, the CDC’s recommendations include, but are not limited to, proper hygiene techniques, proper sanitation of equipment before and after use, social distancing, and submitting to temperature checks and screenings prior to Academy access.

I hereby attest that I have not experienced one or more severe symptoms associated with COVID-19 (including, without limitation-Cough: Shortness of Breath or Difficulty Breathing: Chills or Repeated Shaking with Chills; Runny Nose; Fatigue; Sore Throat; Muscle Pain; Headache; Loss of Taste or Smell) within the las fourteen days, or am still within a quarantine period as recommended by a healthcare provider. I understand and acknowledge that I will not be granted access to the Academy’s facilities if I record a temperature of 100.4 degrees or greater and that by entering the Academy on each visit, I make an affirmative attestation to this statement.

I also acknowledge that the Los Angeles Jiu-Jitsu Academy has asked all Members and guests to refrain from visiting or using the Academy’s facilities if they are experiencing any signs of respiratory illness such as a fever, cough, shortness of breath or loss of smell or taste. Any Member or guest who experiences these symptoms while at the Academy’s premises is instructed to leave immediately, inform the Instructor and General Manager, contact their healthcare provider, and follow guidelines established by the CDC. By executing or acknowledging this consent and acknowledgement, I hereby certify the statements set forth herein on the date of certification an on each date I make a reservation to attend the Academy, or arrive at the Academy. I acknowledge that it is my duty to revoke this certification as it relates to future dates in writing if I can no longer make the attestation contained herein.

While I understand that the Los Angeles Jiu-Jitsu Academy has taken what it, in its sole discretion, deems to be commercially reasonable steps to attempt to prevent its employees or Members and guests from contracting the virus at the Academy, I am electing to enter the Academy and participate in the Academy activity at my own risk and notwithstanding any actions or inactions taken by the Academy. Further still, I understand and acknowledge that the Academy, by taking any steps that it deems reasonable, is not assuming any duties to me or anyone related to me. I hereby acknowledge and assume the risk of becoming infected by infectious diseases including but not limited to MRSA, influenza, and COVID-19 by being at the Academy and assume all economic risks including, but not limited to paying for medical bills, the risk that I may lose income or be incapable of fulfilling my job responsibilities should I become infected.

While particular rules and personal discipline may reduce the risk, the risk of serious illness and death does exist; and, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, assume full responsibility for my participation; and, I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases.

In addition to the waiver and release within my Membership Agreement and/or provided for in allowing a guest access, I further acknowledge and agree that I expressly assume any and all risks associated with accessing and/or using the Academy’s facilities, whether known or unknown and whether foreseen or unforeseen, including but not limited to exposure to third parties and any illnesses or communicable diseases they may be carrying, including without limitation COVID-19.

I understand that COVID-19 is a contagious respiratory illness and that the United States,  California, and this County have declared emergencies at various times related to COVID-19. I further understand that COVID-19 is contagious and is believed to spread by person-to-person contact. I understand that it is believed that the virus can live on and be transmitted through contact with surfaces. While there is presently no vaccine available for COVID-19, I have elected to leave my home and come to this Academy facility. I was and am under no obligation to come to the Academy facility and do so at my own election. I further acknowledge that notwithstanding any respiratory issues, compromised immune system, or other factors that put me at high risk for COVID-19 complications I am knowingly and voluntarily choosing to visit the Academy.

I acknowledge and agree that I may be required to a temperature check and screening collectively the “Screening”) voluntarily in order to visit and/or utilize the Academy’s facilities on each visit. I understand that the Screening is not diagnostic, and it only seeks to determine whether I have symptoms currently associated with COVID-19. I acknowledge that the Screening does not create a patient/healthcare provider relationship with the Club, and that I should seek medical advice if I have any questions or concerns regarding my health or the outcome of the Screening. If applicable, I hereby authorize the Academy to take my temperature reading and ask questions regarding my potential exposure to, and symptoms of respiratory illness does not mean that I have COVID-19. Conversely, I acknowledge that the lack of an elevated temperature reading or symptoms does not mean that I do not have COVID-19.

I understand that Los Angeles Jiu-Jitsu Academy has made this document available to me and that I have had the opportunity to hire counsel at my own expense to evaluate the document prior to signing.

THIS DOCUMENT IS INTENDED TO BE ABD IS A BINDING AGREEMENT THAT AFFECTS MY RIGHTS AND MY ABILITY TO HOLD OTHERS RESPONSIBLE/LIABLE FOR ANY DAMAGES, INJURIES, OR CLAIMS I MAY OTHERWISE HAVE, THIS DOCUMENT SUPERSEDES ANY CONTRARY TERMS IN MY MEMBERSHIP AGREEMENT.

I HAVE READ AND UNDERSTAND THIS MEMBER & GUEST CONSENT. I AM VOLUNTARILY SIGNING THIS CONSENT AND HAVE DONE SO WITHOUT DURESS OR UNDUE INFLUENCE. I FURTHER UNDERSTAND THAT, BY SIGNING IT, I AM RELEASING CERTAIN LEGAL RIGHTS I MIGHT OTHERWISE HAVE.

Name:{name}          Date of Birth: {dob}   

Guardian/Emergency Contact: {contact_name}               Relation:{contact_relation}

Phone: {phone}

Date: {sign_date}