Please fill out and sign the following
prior to the start of your first class at Mile-End Jiu-Jitsu Club
I understand and agree that:
In consideration of being allowed to learn Brazilian Jiu-Jitsu and Self-Defense and to participate in any way in the sports programs, tournaments, seminars, related events, and activities, including transportation to and from such events, of the Brazilian Jiu-Jitsu Revolution Team Montreal/Mile-End Jiu-Jitsu Club, and its affiliated clubs, and schools, I hereby:
1- Agree that prior to participating, I will inspect the mats, equipment, facilities, and any competition pools or parings to be used, and if I believe anything to be unsafe or beyond my capability, I will immediately advise my instructors, coaches or supervisors of such conditions and refuse to participate.
2- Acknowledge and fully understand that Brazilian Jiu-Jitsu and self-defense are a physical sport and that `I will be engaging in activities that might result in serious injuries, including permanent disability or death, and severe social and economic loss due not only to my actions, inaction or negligence, but the actions, inaction or negligence of others, the rules of the sport of Brazilian Jiu-Jitsu and the self-defense, or conditions of the premises or of any equipment used. Further, I acknowledge that there may be other risks not known to me or not foreseeable at this time.
3- Assume all risks involved in the sport of Brazilian Jiu-Jitsu and self-defense and accept personal responsibility for the damages following such injury, permanent disability, and death.
4-Enter Brazilian Jiu-Jitsu and self-defense practice, seminar training, or competition entirely of my own free will and understand the importance of following the rules of the sport of Brazilian Jiu-Jitsu and self-defense and all the directions and instructions given to me by my instructors, coaches, and all other Brazilian Jiu-Jitsu and self-defense officials.
5- Certify that I am in good physical and psychological conditions, and have no disease, injury, or other conditions that would impair my performance or physical and psychological well being in intense physical and psychological practice, training, or competition.
6- Grant permission in case of injury to have a doctor, nurse, athletic trainer, or another emergency medical personnel provide me with medical assistance or treatment for such injury.
7- Release, waive, discharge, and covenant not to sue the Brazilian Jiu-Jitsu Revolution Team Montreal/Mile-End Jiu-Jitsu Club, other participants, and Jiu-Jitsu and self-defense organizations, their affiliated schools and clubs, their respective administrators, directors, agents, coaches, and other employees or volunteers or the organizations, event officials, medical personnel, other participants, their parents, guardians, supervisors, coaches, sponsoring agencies, sponsors, advisors, and if applicable, owners and lessors of premises used to conduct the class or event, all of which are here and after referred as < release> from any and all claims, demands losses, or damages on account of injury, including permanent disability and death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the release or otherwise.
8-During the course of instruction, employees of the Brazilian Jiu-Jitsu Revolution Team Montreal/Mile-End Jiu-Jitsu Club, and or instructors, students or authorized persons will be engaged in a course of conduct requiring physical contact, I give full consent to such contact as is required by training.
9- I, We the parent(s) or guardian(s)
10- Of this minor participant, have instructed or will instruct the minor participant to the above warning and conditions and their ramifications, I, We additionally will confirm and agree to all the above statements, condition waivers, releases, and consent to the participation of this minor.
I understand and I agree that I am following this list of conditions prior to each training sessions at Mile-End Jiu-Jitsu Club:
I don’t have any Covid-19 symptoms like:
-shortness of breath or difficulty breathing
-repeated shaking of chills
-new loss of taste or smell
No known contacts with anyone COVID 19 positive within past 14 days unless I had received two doses of vaccine approved by Health Canada
Not recently coming back from another country (finish 14 days quarantine before coming back to the gym or test negative or received two doses of vaccine approved by Health Canada)
Is, neither a member of nor lives with, a member of a population unvaccinated and uniquely vulnerable to COVID 19 including:
-people 65 and older
-people who live in a nursing home or long term care facility
And people of all ages unvaccinated with the following medical conditions:
-Chronic lung disease (i.e. chronic bronchitis, emphysema, moderate to severe asthma, pulmonary fibroses, Cystic fibroses)
-Serious heart conditions (i.e. congestive heart failure, coronary artery disease, poorly controlled high blood pressure)
-peripheral artery disease, history of blood clots in the limbs
-immunocompromised states (i.e. transplant recipients, persons being treated for cancer, and anyone taking any medication known to suppress immune system)
-severe obesity (body mass index of 40 or higher)
-chronic kidney disease
-chronic liver disease
I understand and I agree that it is my responsibility to ensure other people safety and communicate with Mile-End Jiu-Jitsu Club directly in case of a potential outbreak at the gym.
Welcome to Mile-End Jiu-Jitsu Club!!