Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 2Name *FirstLastParents/Guardians Full Name *FirstLastEmail * Do referral have MobileAddress *Address Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryDate of Birth *Do you have a history of a significant medical condition such as: *Heart disease (e.g. ischaemic heart disease/heart failure)Significant back/neck/joint problemsRespiratory disease (e.g. asthma)Neurological disease (e.g. epilepsy)None of the aboveAny other significant medical problems we should know about? (e.g. severe allergies)Choose the most important benefits you would like to get through the Jiu Jitsu. *ExerciseSelf DefenceAnti StressRespectSelf ConfidenceConcentrationCoordination/BalanceFocusFunCompetitionBe a championIf you are here by referral could you please let us know their name?NextBlue Mountains Jiu Jitsu Academy Youth Participation Waiver & Release of Liability (For participants under 18 years of age) To the Parent/Guardian: As the parent or legal guardian of the minor named below, I understand that my child’s participation in martial arts training at Blue Mountains Jiu Jitsu Academy involves physical contact and inherent risks, including sparring, grappling, and MMA drills. I voluntarily consent to my child’s participation and agree to the terms below on their behalf. 1. Acknowledgment of Risks I recognize and understand that: Martial arts training, including sparring, grappling, and MMA, is a physical contact activity that may result in serious injury, permanent disability, or death, as well as social and economic losses. Such risks may arise from: My child’s own actions. The actions, inaction, or negligence of other participants (including during sparring/grappling). The rules of participation, conditions of the premises, or equipment used. Unknown or unforeseen risks, including those specific to children (e.g., growth plate injuries, concussions). I specifically acknowledge that sparring and grappling carry a high risk of injury, including injuries caused by other children or instructors. 2. Inspection and Safety I agree to inspect the facilities, equipment, and training pairings before my child participates. I will immediately inform an instructor if I believe anything is unsafe or beyond my child’s capability. I understand that my child must follow all safety rules, including using protective gear (e.g., mouthguard, headgear for striking) during sparring/grappling. I authorize instructors to remove my child from training if they deem their behavior unsafe. 3. Assumption of Risk I assume all risks associated with my child’s participation, including participant-to-participant injuries during sparring or grappling. I accept full responsibility for any damages, injuries, or losses my child may suffer, including those caused by other participants. I understand that Blue Mountains Jiu Jitsu Academy does not provide liability insurance for injuries caused during sparring or grappling. 4. Medical Consent and Release I certify that my child is in good physical and mental health and has no conditions that would impair their ability to train safely. I grant permission for instructors or medical personnel to provide emergency treatment if my child is injured. I release the academy from liability for any medical expenses incurred as a result of my child’s participation. 5. Release of Liability I, on behalf of my child and our family, release, waive, discharge, and covenant not to sue Blue Mountains Jiu Jitsu Academy Pty Ltd, its affiliates, officers, instructors, personnel, participants, supervisors, landlords, and premises owners from any and all liability for: Injuries, death, or property damage arising from my child’s participation, including those caused by other participants during sparring or grappling. Negligence or actions of the academy, instructors, or other participants. The absence of direct supervision during open mat or sparring sessions. This release applies to all claims, including those based on negligence or breach of contract. 6. Indemnification I agree to indemnify and hold harmless Blue Mountains Jiu Jitsu Academy from any claims, damages, or liabilities arising from my child’s actions or my failure to disclose relevant medical information. 7. Compliance with Rules I agree that my child will follow all academy rules, including: Using protective gear during sparring/grappling. Training responsibly and stopping if they feel unsafe. Respecting instructors and fellow participants. I understand that failure to comply may result in my child’s removal from training. 8. Video Recording and Photography I consent to my child being recorded during training for safety, instructional, or promotional purposes. I waive any privacy claims related to these recordings. 9. Legal Enforceability I acknowledge that this waiver is a legally binding contract. I certify that I am the parent/legal guardian of the minor named below and have the authority to sign this waiver on their behalf. I understand that this waiver is governed by the laws of New South Wales, Australia. 10. Severability If any portion of this waiver is found unenforceable, the remaining portions shall remain in full effect. By clicking 'Submit,' I confirm that: I have read, understood, and voluntarily agreed to all terms above. I consent to my child’s participation in martial arts training, including sparring and grappling. I accept full responsibility for my child’s safety and the risks involved. Submit