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Student Waiver

I, have enrolled in the personalized health, fitness and martial arts program offered through Sion Brazilian JiuJitsu. I recognize that the program may involve strenuous physical activity including, but not limited to, muscle strength and endurance training, cardiovascular conditioning and training, and other various fitness activities. I hereby affirm that I am in good physical condition and do not suffer from any known disability or condition which would prevent or limit my participation in this exercise program. I acknowledge that my enrollment and subsequent participation in purely voluntary and in no way mandated by Sion Brazilian Jiujitsu

In consideration of my participation in this program, I, hereby release Sion Brazilian Jiujitsu and its agents from any claims, demands, and causes of action as a result of my voluntary participation and enrollment. I fully understand that I may injure myself as a result of my enrollment and subsequent participation in this program and I, hereby release Sion Brazilian Jiujitsu and its agents from any liability now or in the future for conditions that I may obtain. These conditions may include, but are not limited to, heart attacks, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, heat prostration, injuries to knees, injuries to back, injuries to foot, or any other illness or soreness that I may incur, including death

I HEREBY AFFIRM THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE STATEMENTS.

TODAY'S DATE: May 15, 2025

First Student's Name
First Name*
Middle Name
Last Name*
Phone*
Select Gender
First Student's Date of Birth*
Date of Birth
First Student's Signature*
Second Student's Name
First Name*
Middle Name
Last Name*
Phone*
Select Gender
Student's Date of Birth*
Date of Birth
Third Student's Name
First Name*
Middle Name
Last Name*
Phone*
Select Gender
Student's Date of Birth*
Date of Birth
Fourth Student's Name
First Name*
Middle Name
Last Name*
Phone*
Select Gender
Student's Date of Birth*
Date of Birth
Fifth Student's Name
First Name*
Middle Name
Last Name*
Phone*
Select Gender
Student's Date of Birth*
Date of Birth
Sixth Student's Name
First Name*
Middle Name
Last Name*
Phone*
Select Gender
Student's Date of Birth*
Date of Birth
Seventh Student's Name
First Name*
Middle Name
Last Name*
Phone*
Select Gender
Student's Date of Birth*
Date of Birth
Eighth Student's Name
First Name*
Middle Name
Last Name*
Phone*
Select Gender
Student's Date of Birth*
Date of Birth
Ninth Student's Name
First Name*
Middle Name
Last Name*
Phone*
Select Gender
Student's Date of Birth*
Date of Birth
Tenth Student's Name
First Name*
Middle Name
Last Name*
Phone*
Select Gender
Student's Date of Birth*
Date of Birth
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*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Middle Name
Last Name*
Relationship*
Phone*
Select Gender
Student's Date of Birth*
Date of Birth
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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