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Tim Burrill Brazilian Jiu-Jitsu

55 Porter Street, Providence, RI 02905

    401-374-5759

 

RELEASE AND INDEMNIFICATION

IN CONSIDERATION OF THE SERVICES OF TIM BURRILL BRAZILIAN JIU-JITSU, THEIR AGENTS, VOLUNTEERS, PARTICIPANTS, EMPLOYEES, OWNERS AND ALL ENTITIES ACTING ON THEIR BEHALF COLLECTIVELY REFERRED AS TIM BURRILL BRAZILIAN JIU-JITSU HEREAFTER, I HEREAFTER AGREE TO RELEASE AND DISCHARGE TIM BURRILL BRAZILIAN JIU-JITSU ON BEHALF OF MYSELF, MY CHILDREN, MY PARENTS, HEIRS, ASSIGNS AND ESTATE AS FOLLOWS:

A. I KNOW THE STUDY AND TRAINING OF MARTIAL ARTS LIKE JUDO, JIU-JITSU, KICKBOXING, MUAY THAI AND SELF DEFENCE ENTAILS KNOWN 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, SOME OF THESE RISKS INCLUDE BUT ARE NOT LIMITED TO: HEART ATTACK, BRUISES, BROKEN BONES, OR SERIOUS INJURY.

B. I AGREE AND PROMISE TO ACCEPT AND ASSUME ALL RISKS EXISTING IN THIS ACTIVITY. MY PARTICIPATION IS COMPLETELY VOLUNTARY AND I WANT TO PARTICIPATE DESPITE THE KNOWN AND UNKNOWN RISKS.

C. I RECOGNIZE THAT PARTICIPATION INCLUDES BODY CONTACT AND GRABBING OF VARIOUS BODY PARTS.

D. I HEREBY VOLUNTARILY RELEASE, FOREVER DISCHARGE, AND AGREE TO INDEMNIFY AND HOLD HARMLESS TIM BURRILL BRAZILIAN JIU-JITSU FROM ANY AND ALL CLAIMS, DEMANDS OR CAUSES OF ACTION. WHICH ARE IN ANY WAY CONNECTED TO MY PARTICIPATION IN THIS ACTIVITY OR USE OF EQUIPMENT, OR FACILITIES INCLUDE ANY SUCH CLAIMS WHICH ALLEGE NEGLIGENT ACTS OR OMISSIONS OF TIM BURRILL BRAZILIAN JIU-JITSU.

E. SHOULD TIM BURRILL BRAZILIAN JIU-JITSU OR ANY ONE ACTING ON THEIR BEHALF BE REQUIRED TO INCUR ATTORNEY FEES AND COSTS TO ENFORCE THIS AGREEMENT I AGREE TO INDEMNIFY AND HOLD THEM HARMLESS FOR ALL SUCH FEES AND COSTS.

F. 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 PROBLEMS. I FURTHER CERTIFY I HAVE NO MEDICAL CONDITION, WHICH COULD INTERFERE WITH MY SAFETY OR PARTICIPATION IN SUCH ACTIVITY BY ANY SUCH CONDITION.

MY SIGNING THIS DOCUMENT, I ACKNOWLEDGE THAT IF ANYONE IS HURT OR PROPERTY IS DAMAGED I MAY BE FOUND BY A COURT OF LAW TO HAVE WAIVED MY RIGHT TO MAINTAIN A LAW SUIT AGAINST TIM BURRILL BRAZILIAN JIU-JITSU AND ITS EMPLOYEES, AGENTS, VOLUNTEERS, PARTICIPANTS OR ENTITIES ON THE BASIS OF ANY CLAIM FORM WHICH I HAVE RELEASED THEM HEREIN. I HAVE READ AND COMPLETELY UNDERSTAND THIS DOCUMENT AND I AGREE TO BE BOUND BY ITS TERMS.


Today's Date: February 6, 2023

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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.


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