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Coronavirus/COVID-19 Waiver
Liability Training Release

Assumption of the Risk and Waiver of Liability Relating to the Coronavirus/Covid‐19

Assumption of the Risk and Waiver of Liability Relating the Coronavirus/Covid‐19

The novel coronavirus, COVID‐19, has been declared a worldwide pandemic by the World Health
Organization. COVID‐19 is extremely contagious and is believed to spread mainly from person‐to‐person
contact. As a result, federal, state, and local governments and federal and state health agencies
recommend social distancing and have, in many locations, prohibited the congregation of groups of
people.

RONIN BJJ AND FITNESS LLC (“Ronin”) has put in place preventative measures to reduce the spread of
COVID‐19; however, the Ronin cannot guarantee that you or your child(ren) will not become infected
with COVID‐19. Further, attending any class or activity at Ronin could increase your risk and your
child(ren)’s risk of contracting COVID‐19.

By signing this agreement, I acknowledge the contagious nature of COVID‐19 and voluntarily assume the
risk that my child(ren) and I may be exposed to or infected by COVID‐19 by attending Ronin and that
such exposure or infection may result in personal injury, illness, permanent disability, and death. I
understand that the risk of becoming exposed to or infected by COVID‐19 at Ronin may result from the
actions, omissions, or negligence of myself and others, including, but not limited to, Ronin employees,
volunteers, and program participants and their families.

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my
child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage,
loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in
connection with my child(ren)’s attendance at Ronin or participation Ronin programming (“Claims”). On
my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold
harmless Ronin, its employees, agents, and representatives, of and from the Claims, including all
liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I
understand and agree that this release includes any Claims based on the actions, omissions, or
negligence of Ronin, its employees, agents, and representatives, whether a COVID‐19 infection occurs
before, during, or after participation in any Ronin program.

First Students Name

First Name*

Last Name*

Phone*
First Students Date of Birth*
First Students Signature*
Second Students Name

First Name*

Last Name*
Second Students Date of Birth*
Third Students Name

First Name*

Last Name*
Third Students Date of Birth*
Fourth Students Name

First Name*

Last Name*
Fourth Students Date of Birth*
Fifth Students Name

First Name*

Last Name*
Fifth Students Date of Birth*
Sixth Students Name

First Name*

Last Name*
Sixth Students Date of Birth*
Seventh Students Name

First Name*

Last Name*
Seventh Students Date of Birth*
Eighth Students Name

First Name*

Last Name*
Eighth Students Date of Birth*
Ninth Students Name

First Name*

Last Name*
Ninth Students Date of Birth*
Tenth Students Name

First Name*

Last Name*
Tenth Students Date of Birth*
Students 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*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Insurance

Insurance Carrier*

Insurance Policy Number*
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
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*

Last Name*

Relationship*

Phone*
Parent or Guardian's 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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