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RELEASE OF LIABILITY WAIVER FORM

This agreement is between ALLIANCE KIOTO BRAZILIAN JIU JITSU LLC (DBA KIOTO BJJ CHATTANOOGA), hereafter referred to as KIOTO BJJ CHATTANOOGA, and . Hereafter referred to as “member”. This agreement is entered on {sign_date}.

THE RESPONSIBLE PARTY MUST READ THE ENTIRE RELEASE OF LIABILITY WAIVER FORM BEFORE SIGNING.

PARTICIPANT AGREEMENT, RELEASE, AND ACKNOWLEDGEMENT OF RISK: I, , recognize the risks of injury that are common to any performing arts program that my minor child or I participate in and I do hereby waive and release KIOTO BJJ CHATTANOOGA from and against any and all claims, actions, causes of action, damages, costs, liabilities, expense of judgments, including attorney's fees and court costs, that arise out of my participation in this program. I hereby execute this Release of Liability Waiver Form permitting my minor child and/or myself to participate in KIOTO BJJ CHATTANOOGA’s program.

1. I, , acknowledge that participation in the Martial Arts entails unknown and unanticipated risks to myself and/or my minor child which could result in physical or emotional injury, paralysis, death, or damage to myself, to property or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. The risks include, among other things: intense, stressful and strenuous exercise and body contact. I expressly consent to confront these known and unknown dangers and further agree, understand and recognize that these risks may result in serious injury or illness including but not limited to: bruise, bloody noses, broken bones, heart attacks or other cardiovascular disease, or other serious injury resulting in death and/or property damage. Furthermore, KIOTO BJJ CHATTANOOGA employees have difficult jobs to perform. They seek safety, but they are not infallible. They might be ignorant of a participant’s fitness ability. They may give inadequate warning or instruction, and the equipment being used might malfunction.
2. I, , expressly agree and promise to accept and assume all of the risks existing in this activity. My participation is purely voluntary, and I elect to participate in spite of the risks.
3. I, , hereby Voluntarily release, forever discharge, and agree to indemnify and hold harmless, KIOTO BJJ CHATTANOOGA from any and all claims, demands, or causes of action, which are in any connected with my participation in this activity or my use of KIOTO BJJ CHATTANOOGA’s equipment or facilities, including any such claims which allege negligent acts or omissions of KIOTO BJJ CHATTANOOGA.
4. Member and family agree and consent that pictures and videos of themselves and/or relatives may be used for publicity purposes.
5. Should KIOTO BJJ CHATTANOOGA, or anyone acting on their behalf, be required to incur attorney’s fees and cost to enforce this agreement, I, , agree to indemnify and hold them harmless for all such fees and costs.
6. I, , certify that I have adequate insurance to cover an injury or damage I may cause or suffer while participating, or else I agree to bear the cost of such injury or damage myself. I further certify that I have no medical or physical condition which interferes with my safety in this activity, or else I am willing to assume and bear the cost of all risks that may be created, directly or indirectly, by any such condition.
7. In the event that I file a lawsuit against KIOTO BJJ CHATTANOOGA, I, , agree to do so solely in the State of Tennessee, and I further agree that the substantive law of that state shall apply in the action without regard to the conflict of law rules of the state.
8. KIOTO BJJ CHATTANOOGA has the right to refuse or cancel any membership due to misconduct, in the eyes of the Association, and/or noncompliance with the terms and conditions set forth herein and at the training facility.
9. By signing this document, I, , acknowledge that if anyone is hurt or property is damaged by my participation in this activity, I, by a court of law, have waived my right to maintain a lawsuit against ALLIANCE KIOTO BRAZILIAN JIU JITSU LLC (DBA KIOTO BJJ CHATTANOOGA),, on the basis of any claim from which I have released them herein. I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.
10. Parents or Guardian's additional indemnification (for participants under the age of 18): In consideration of my Minor Child being permitted by (myself) to participate in its activities and to use equipment and facilities, I further agree to indemnify and hold harmless KIOTO BJJ CHATTANOOGA, from any and all claims which are brought by or on behalf of "Minor" and which are in any way connected with such use or participation by "Minor." 

By signing below, I, , acknowledge to have read (or to have had read to me) the terms of this Release of Liability Waiver in its entirety. This agreement, and its information, will remain on file in a secure location, within KIOTO BJJ CHATTANOOGA’s office unless the terms and conditions change. At that time, a new contract will be executed.