Free Trial

Please complete this form to participate and begin your free 3-day trial offer.
Participant Information
Guardian Information (only if participant is under 18 years old)
Emergency Contact Information
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Waiver & Release of Liability
On behalf of myself and/or my minor child, I agree to participate in Brazilian Jiu-Jitsu at Primitive Jiu Jitsu Academy, assuming all risks and responsibilities.

I HEREBY:
1. I acknowledge the risks and hazards connected with the participation of adults/kids in Brazilian Jiu-Jitsu, Grappling, Self-Defense, and Strength Training. This includes physical injury or death. I hereby elect to voluntarily participate in said event, knowing that the associated physical activity may be hazardous to me and my property.

2. I hereby release, waive, and concur through this contract not to sue, Primitive Jiu-Jitsu Academy, Elijah Pizarro, their office, and employees (hereinafter referred to as RELEASEES).

3. I represent that I have health insurance and do not have any undisclosed medical conditions. I have adequate insurance to cover any injury or damage I may attain or cause while participating in this activity, or else I agree to bear the costs of such injury or damage myself.

4. I acknowledge that this document is a contract and agree that if a lawsuit is filed against Primitive Jiu-Jitsu Academy, employees, or instructors for any injury or damage is in breach of this contract, the “Undersigned” will pay all attorney’s fees and costs incurred by Primitive Jiu-Jitsu Academy in defending such an action.

5. In signing this release, I acknowledge and represent that I have carefully read The Waiver and Release of Liability, understand it, and sign it voluntarily as my free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreements have been made.I have made a free and deliberate choice to sign this Waiver and Release as a condition to allow me and/or my child to participate in Brazilian Jiu-Jitsu and physical activities. I have concluded that the risks involved and the release and waiver of liability are worth the pleasure of this experience.