Full Name of Student *

Parent/Guardian Name (If Available)

Date of birth *

Address

Street Address

City

State

Country

Postal Code

Phone *

Email *

Emergency Contact Name *

Emergency Contact Phone *

Relationship *

Required Acknowledgments *

I understand martial arts involve risk of serious injury or death.

I voluntarily assume all risks associated with participation.

I certify that I am physically able to participate.

I understand sparring and physical contact are voluntary and increase the risk of injury.

I release Ohana Jiu Jitsu Academy from liability to the fullest extent permitted by Florida law.

I agree to follow all Academy rules and safety policies.

I understand the Academy is not responsible for lost or stolen property.

I authorize emergency medical treatment if necessary.

I consent to the use of photographs and videos for Academy marketing.

I consent to receive emails, texts, and phone communications from the Academy.

I understand this Agreement is governed by Florida law.

I have read and understand this waiver.

Participant Signature *

Parent/ Guardian Signature

Date Signed *