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Third Law Academy - Training Waiver

Today’s Date: May 28, 2020

THIRD LAW, LLC
Participant Agreement, Release, and Acknowledgement of Risk

In consideration of the services of Third Law, LLC, Roberto Torralbas, their agents, owners, officers, volunteers, participants, employees, and all other persons or entities who act in any capacity on their behalf (hereinafter collectively referred to as “Third Law Brazilian Jiu-Jitsu”), I hereby agree to release and discharge Third Law, LLC, Roberto Torralbas, on behalf of myself, my children, my parents, my heirs, assigns, personal representatives, and estate as follows:

  1. I acknowledge that the study and training of Jiu-Jitsu, Wrestling, Thai Boxing, and all other Martial Arts entails known and unanticipated risks 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 exercises 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: bruises, bloody noses, blood-borne pathogens, broken bones, heart attacks, or other cardiovascular diseases, or other serious injury resulting in death and/or property damage. Furthermore, I agree, understand, and recognize that Third Law, LLC Instructors have difficult jobs to perform. The instructors seek safety, but they are not infallible. They might be ignorant of a participant’s fitness or abilities. They may give inadequate warnings 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 in this activity 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 Third Law, LLC from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of Third Law, LLC’s equipment or facilities, including any such claims which allege negligent acts or omissions of Third Law, LLC’s or Roberto Torralbas.
     
  4. Should Third Law. LLC, Roberto Torralbas, or anyone acting on their behalf be required to incur attorneys’ fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.
     
  5. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I have no medical or physical conditions which could interfere with my safety in this activity, or else I am willing to assume – and bear the costs of all- risks that may be created, directly or indirectly, by any such condition.
     
  6. In the event that I file a lawsuit against Third Law, LLC or Roberto Torralbas, I agree to do so solely in the state of Florida, and I further agree that the substantive law of that state shall apply in that action without regard to the conflict of law rules of that state.

By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a law suit against Third Law, LLC or Roberto Torralbas, on the basis of any claim from which I have released them herein.

I HAVE READ THIS PARTICIPANT AGREEMENT, RELEASE, AND ACKNOWLEDGEMENT OF RISK, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW

Please select who will be participating...
AdultMinor
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First Student's Name

First Name*

Middle Name

Last Name*

Phone*
First Student's Date of Birth*
First Student's Information

Mother (Guardian)

Occupation

Phone #

Father (Guardian)

Occupation

Phone #

Student Occupation:

Work #:
Yes! Please Mail Me a Free Instructional DVD! (check which you would like)
Kids Martial Arts: 5 Bully Proof Self Defense Techniques Your Child Must Know
Adults, Juniors & Teens: An Intro Course in Brazilian Jiu Jitsu: Tournament Tested Techniques
Adults, Juniors & Teens: Muay Thai 101: Come to Class Prepared
How did you hear about us?*

If Referral or Birthday, please specify:
What Team Third Law Programs are you most interested in? (Check all that apply)
Kids Martial Arts (ages 4-12: Mini Ninjas, Tiny Ninjas, Little Ninjas, Juniors, Black Belt Club)
After School Martial Arts & Tutoring Program
Summer Camp
Teens Brazilian Jiu Jitsu & Muay Thai Kickboxing (ages 13 to 17)
Brazilian Jiu Jitsu (age 18+)
Muay Thai Kickboxing (age 18+)
Women-Only Jiu Jitsu (Teens & Adults)
Competition Team / Combat Gold & Mastery Advanced Classes
30 + Drill & Flow Class (Intermediate & Advanced)
Are you currently teaching and/or enrolled in a martial arts program?*
No
Yes

Martial Arts Background: *

Special Conditions (physical or mental conditions we should know about to keep you or your child safe):

What are the two main goals you hope to achieve through training?


1. *

2. *
First Student's Signature*
Student's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

Emergency Contact: *

Emergency Contact Phone #: *

Relation: *

Email: *
ust be completed for participants under the age of 18) In consideration of minor (“Minor”) being permitted by Parent/Guardian to participate in its activities and to use its equipment and facilities, I further agree to indemnify and hold harmless Third Law, LLC and Roberto Torralbas, 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.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Mother (Guardian)

Occupation

Phone #

Father (Guardian)

Occupation

Phone #

Student Occupation:

Work #:
Yes! Please Mail Me a Free Instructional DVD! (check which you would like)
Kids Martial Arts: 5 Bully Proof Self Defense Techniques Your Child Must Know
Adults, Juniors & Teens: An Intro Course in Brazilian Jiu Jitsu: Tournament Tested Techniques
Adults, Juniors & Teens: Muay Thai 101: Come to Class Prepared
How did you hear about us?*

If Referral or Birthday, please specify:
What Team Third Law Programs are you most interested in? (Check all that apply)
Kids Martial Arts (ages 4-12: Mini Ninjas, Tiny Ninjas, Little Ninjas, Juniors, Black Belt Club)
After School Martial Arts & Tutoring Program
Summer Camp
Teens Brazilian Jiu Jitsu & Muay Thai Kickboxing (ages 13 to 17)
Brazilian Jiu Jitsu (age 18+)
Muay Thai Kickboxing (age 18+)
Women-Only Jiu Jitsu (Teens & Adults)
Competition Team / Combat Gold & Mastery Advanced Classes
30 + Drill & Flow Class (Intermediate & Advanced)
Are you currently teaching and/or enrolled in a martial arts program?*
No
Yes

Martial Arts Background: *

Special Conditions (physical or mental conditions we should know about to keep you or your child safe):

What are the two main goals you hope to achieve through training?


1. *

2. *
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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