Gentlemen’s Jiu Jitsu, LLC
931 National Avenue
Lexington,KY 40502

Express assumption of risk: I, the undersigned, am aware that there are significant risks involved in all aspects of physical training. These risks include, but are not limited to: falls or other types of physical contact which can result in serious injury or death, injury or death due to my own negligence, or that of my training partner, or other people around me, and/or injury or death due to improper use or failure of equipment. I am aware that any of these above mentioned risks may result in serious injury or death to myself and/or my partner(s). I willingly assume full responsibility for the risks that I am exposing myself to and accept full responsibility for any injury or death that may result from participation in any activity or class while at Gentlemen’s Jiu Jitsu, LLC. I, the undersigned acknowledge that I have no physical impairments or illnesses that will endanger myself or others.

Release: In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willingly and voluntarily participating in the activities available at Gentlemen’s Jiu Jitsu, LLC, I, the undersigned hereby release Gentlemen’s Jiu Jitsu, LLC, their owners, principals, agents, employees, and volunteers from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my participation in this activity, including those allegedly attributed to the negligent acts or omissions of Gentlemen’s Jiu Jitsu, LLC, their owners, principals, agents, employees, and volunteers. This agreement shall be binding upon me, any minor child(ren) designated below, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect. If I am signing on behalf of any minor child(ren), I also give full permission for any person connected with Gentlemen’s Jiu Jitsu, LLC to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical and/or surgical care for the child(ren) and to transport the child(ren) to a medical facility deemed necessary for the well being of the child(ren).

Indemnification: I recognize that there is risk involved in the types of activities offered by Gentlemen’s Jiu Jitsu, LLC. Therefore I accept financial responsibility for any injury that I may cause either to myself or to any other participant due to my negligence. Should the above mentioned parties, or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless Gentlemen’s Jiu Jitsu, LLC, their principals, agents, employees, and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional acts or omissions while participating in activities offered by Gentlemen’s Jiu Jitsu, LLC.

I have read and understood the foregoing assumption of risk, and release of liability and I understand that by affixing my signature below, I am obligated to indemnify the parties named for any liability for injury or death of any person and damage to property caused by my negligent or intentional acts or omissions. I further understand that by signing this form I am waiving valuable legal rights and the opportunity to obtain advice from the attorney of my choosing.

PARENTAL CONSENT, (for participants under the age of 18) I, the undersigned parent or legal guardian of the child shown above, have read the above and understood the foregoing assumption of risk, and release of liability and indemnification and agree to its terms on behalf of my child and myself. I understand that by signing below, I am giving up substantial rights on behalf of my child and myself.

the undersigned