Participant Legal Name:
Participant Date of Birth:
Name of Person Signing (must be 18 or older):
Category Five Jiu-Jitsu Release of Liability Waiver Form
THE PARTICIPANT AGREES TO COMPLY WITH THE RULES OF THE ACADEMY AND ACKNOWLEDGES THAT TRAINING CAN RESULT IN SIGNIFICANT INJURY, INCLUDING DEATH, TO THE PARTICIPANT. The participant hereby waives any claim of accident and/or negligent tort damages or injury against Richard Wesley Thompson, Category Five Jiu-Jitsu LLC., Scott Layton, Mountain State Jiu-Jitsu LLC., or any of their owners or instructors, officers, agents or employees or any individual connected with the organization or promotion of the Association or Academies and expressly assumes an assumption of risk of whatever nature resulting from participation.
The participant acknowledges that he/she is fully aware of his/her personal medical condition and hereby certifies that he/she is mentally, emotionally, and physically fit to train Jiu-Jitsu/Martial Arts/Judo/Boxing/Fitness. Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and, KNOWINGLY AND FREELY ASSUMES ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERS AND ASSUME FULL RESPONSIBILITY FOR MY PARTICIPATION.
If the participant observes any unusual or significant behavior or hazard during their presence or participation, the participant will remove themselves from participation and bring such behavior or hazard to the attention of the nearest official immediately.
By signing below, the participant for themselves and, on behalf of their heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, HOLD HARMLESS, WAIVE, DISCHARGE AND COVENANT NOT TO SUE Richard Wesley Thompson, Category Five Jiu-Jitsu LLC., Scott Layton, Mountain State Jiu Jitsu LLC., their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL LIABILITY, CLAIMS, DEMANDS, AND ACTIONS AND CAUSES OF ACTION WHATSOEVER ARISING OUT OF OR RELATED TO ANY LOSS, DAMAGE OR INJURY, INCLUDING DEATH, ILLNESS, DISABILITY, OR LOSS OR DAMAGE TO PERSON OR PROPERTY, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, TO THE FULLEST EXTENT PERMITTED BY LAW.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN I FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION):
This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.
A responsible adult must accompany participants under the age of 18 and be present in the building during classes/training. Management of discipline or medical issues will be deferred to the adult accompanying the child.
By signing below, I certify that I am the adult participant 18 years of age or older, or the parent and/or legal guardian of the participant under 18 years of age, and have fully read and agree to all the terms and information listed in this document.
___________________________________________________________________________________
Category Five Jiu-Jitsu Gym Policies
1. Be a respectful training partner - their safety is in YOUR hands. Sparring and drilling should always be done in a controlled manner.
2. For the safety of our training partners, the following are not permitted: striking, slamming, small joint locks (grabbing/twisting individual fingers or toes), neck cranks, heel hooks in the gi, jumping closed guard, flying scissor takedown, and tani otoshi. Some of these may be allowed during specific training scenarios, but only at the head instructor's discretion. If you are unsure if a technique is acceptable, please ask.
3. Shoes/sandals must be worn at all times except on the mats.
4. No shoes, food, or drinks on the mats. Only drinks with lids on the floor next to the mats. Remove all jewelry prior to training.
5. Only white, black, and royal blue gi colors are permitted. A Jiu-Jitsu gi and belt are required for gi classes.
6. Any color/design no-gi gear is permitted. All images/logos/wording must be family friendly. No pockets or zippers permitted.
7. Make hygiene a priority. Wash your gi, belt, and all gear after every training session. Always shower after training, and before training if needed. Keep nails neatly trimmed.
8. Clean up after yourselves and your children.
9. Do not train if you have been diagnosed with or have symptoms of a communicable/infectious illness. Do not train if you have a rash or possible skin infection (this includes warts on areas of the body exposed while training such as hands or feet). If you participate while having a rash or skin infection you will be banned from this facility.
10. Harassment, bullying, or discrimination is not tolerated.
11. A responsible adult must accompany participants of the kids class and be present in the building during classes/training. Management of discipline or medical issues will be deferred to the adult accompanying the child.
Category Five Jiu-Jitsu Membership and Billing Policies
Dues are paid monthly and automatically through an online billing system.
We do not offer pay-per-class arrangements.
You may cancel your membership or make changes to your membership at any time by contacting Category Five Jiu-Jitsu in writing. At least 48 hours notice prior to the billing date is required.
No refunds for missed classes or unused memberships.
Members are responsible for keeping their payment information up to date and being aware of their billing schedule.
If the payment draft is unsuccessful, you will be notified via email. Please update your payment information if necessary. The payment will automatically be attempted again after 1 week. If unsuccessful again, the membership will be inactivated.
One of our top priorities is maintaining a safe and respectful training environment for all of our students. Therefore, we will deny/cancel the membership of anyone who is behaving in an inappropriate or unsafe manner.
Photos and Videos
Category Five Jiu-Jitsu will occasionally post photos and/or videos from training sessions to our social media pages and/or website. These photos and videos may include some or all of the students in attendance, and there will be no compensation provided for their use. However, Category Five Jiu-Jitsu will always respect the wishes of our students and the parents of our students under the age of 18 regarding sharing images online. If you do not wish to have photos or videos of yourself or your minor child posted online, please notify us and we will refrain from doing so. We also ask that all participants please be respectful and considerate to your training partners if you choose to share any photos or videos to personal social media pages.
By signing below, I certify that I am the adult participant 18 years of age or older, or the parent and/or legal guardian of the participant under 18 years of age, and have fully read and agree to the Category Five Jiu-Jitsu policies listed in this document.