Open Mat Waiver - Blue Mountains Jiu Jitsu Academy

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Name

First

Last

Mobile

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Birth Address medical

Date of Birth

Do you have a history of a significant medical condition such as:

Any other significant medical problems we should know about?

(e.g. severe allergies)

Staff at Blue Mountains Jiu Jitsu Academy will be regularly monitoring the facilities, focusing on:

If a staff member or fellow participant asks you to assist with any of the above, please cooperate to maintain a safe and clean environment.

Health and Safety Acknowledgement

I have not travelled overseas in the past 14 days.
I have not been in contact with anyone confirmed to have COVID-19.
I do not have any symptoms such as fever, cough, runny nose, shortness of breath, or any other viral symptoms.
I agree to wear a clean uniform and rash guard.
I will keep my hands washed or sanitised while at the club.
I will refrain from using foul language while on the premises.

Martial Arts Participation Waiver

I understand that martial arts training involves physical contact, which may result in serious injury, permanent disability, or even death, as well as potential social and economic impacts.
I acknowledge that these risks may arise from my own actions, the actions or negligence of others, participation rules, or conditions of the premises or equipment.
I recognise that there may be other unknown or unforeseen risks at this time.
I agree to inspect the facilities, equipment, and pairings before participating. I will inform an instructor immediately if anything seems unsafe or beyond my ability, and I will not participate if I feel at risk.
I accept all risks and take personal responsibility for any injury, permanent disability, or death that may occur.
I am voluntarily entering martial arts training and/or competition, and I understand the importance of following all rules. I have received a copy of the rules and regulations of the academy and agree to follow them.
I certify that I am in good physical condition and do not have any condition or injury that would impair my ability to train or compete.
In the case of injury, I grant permission for medical personnel to provide treatment if necessary.
I release Blue Mountains Jiu Jitsu Academy Pty Ltd, its affiliates, officers, instructors, personnel, participants, and any premises owners from any liability for injury, death, or property damage, whether caused by negligence or otherwise.

By clicking 'Submit,' you confirm that you have read, understood, and agree to these terms and conditions.