Child Waiver Page

Before your child can start their Journey, you will need to complete the Waiver

KIDS MEMBER WAIVER & RELEASE AGREEMENT

Gracie Barra Staple Hill / Gracie Barra Bristol

IMPORTANT RISK NOTICE

Your child/(ren) is/are about to take part in a potentially dangerous activity. By signing this waiver, you are agreeing not to hold Gracie Barra Staplehill Ltd or its staff or its volunteers or its students or Gracie Barra Bristol Ltd or its staff or its volunteers or its students responsible if your child gets injured. If your child/(ren) get(s) hurt, it is your fault. If you do not agree with this, please do not allow your child(ren) to take part in the classes or the training offered.

I hereby state that I have read, fully understand and agreed with:

  1. The Terms and Conditions for Debit Finance payments
  2. This Waiver and Release Agreement
  3. The Code of Conduct of the Club

I have put forth my signature and thereby agree fully to the terms and agreements as set forth. The acceptance of this application form by the Club shall constitute a valid and binding agreement between Gracie Barra Staplehill Ltd and me.

I hereby state that if I am not present to collect my child at the end of the session, I authorise my child to leave the club premises independently and accept responsibility for their journey and safety once they have left the premises. By signing this waiver, I agree that Gracie Barra Staplehill Ltd and its coaches are not responsible for supervising or accompanying my child after departure.

PARENTAL CONSENT

IF THE MEMBER IS UNDER 18 YEARS OLD, THE PARENT(S) OR LEGAL GUARDIAN(S) MUST SIGN BELOW.

As an inducement to GRACIE BARRA STAPLEHILL LTD and its directors, its instructors, its employees and volunteers reliance on the above PARENTAL CONSENT, I agree to defend, indemnify and hold harmless the GRACIE BARRA STAPLEHILL LTD, AND OR ITS DIRECTORS, AND OR ITS INSTRUCTORS AND OR ITS EMPLOYEES AND OR VOLUNTEERS OR RELEASEES against any and all liabilities, costs, damages, demands, claims and expenses (including without limitation legal fees) of any kind that may hereafter at any time be made or brought by the minor named below or by anyone on his/her behalf, or on behalf of any of them, for the purpose of enforcing a claim for damages on account of any loss, injury, accident, illness or damage, including death to a person or property or delay or inconvenience of any kind sustained or arising out of the aforesaid ACTIVITY, or any use Member’s Likeness right in any media (now known or hereafter devised), including (but not limited to) any such claims or causes of action resulting from or arising out of the negligence of the GRACIE BARRA STAPLEHILL LTD AND OR ITS DIRECTORS, AND OR ITS INSTRUCTORS AND OR ITS EMPLOYEES AND OR ITS VOLUNTEERS OR RELEASEES.

I declare that if I am not present to collect my child at the end of the session, I authorise my child to leave the club premises independently and accept responsibility for their journey and safety once they have left the premises. The club and its coaches are not responsible for supervising or accompanying my child after departure.

ASSUMPTION OF RISKS

Assumption of Risks: ACKNOWLEDGES and AGREES that THE NATURE of Brazilian Jiu Jitsu is A FULL BODY CONTACT martial art and VOLUNTARILY participates in the ACTIVITY FULLY and COMPLETELY AWARE that the ACTIVITY INVOLVES (a) RISK OF ACCIDENTS, SERIOUS BODILY INJURY INCLUDING BUT NOT LIMITED TO PERMANENT DISABLITY and/or PARALYSIS AND DEATH (all of the foregoing collectively, the “HAZARDS”);

(b) OTHER RISKS and SOCIAL and ECONOMIC LOSSES, including but not limited to EMOTIONAL DISTRESS, PSYCHOLOGICAL HARM, PROPERTY DAMAGE and ALL OTHER DANGERS (all of the foregoing collectively, the “RISKS”) not known or not readily foreseeable at this time;

(c) that the HAZARDS and RISKS may be caused by the Member’s own action or inactions, the actions or inactions of others participating in the Activity, the condition in which the activity takes place, or the negligence of the “RELEASEES”.

THE NAMED BELOW FULLY ACCEPT and ASSUME all such HAZARDS and RISKS that MAY OCCUR IN, BEFORE, DURING and/or AFTER such ACTIVITY including but not limited to ALL RESPONSIBILITIES for LOSSES, COSTS and DAMAGES incurred as a result of his/her participation or that of the minor in the ACTIVITY whether due to action or inactions or negligence as above mentioned in (a), (b) and (c).

RELEASE OF LIABILITY

Release of Liability: HEREBY IRREVOCABLY waives, releases, discharges and holds all of the directors, professors/coaches, administrator, affiliates, officers, staff, members and owners of the GRACIE BARRA STAPLEHILL LTD and premises which the ACTIVITY takes place (each considered one of the “RELEASEES”) HARMLESS from and against ALL LOSSES, LIABILITIES, CLAIMS, COSTS, DAMAGES, DEMANDS and EXPENSES ON THE MEMBER’S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR PART BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND CONVENANTS NOT TO SUE THE RELEASEES, (including but not limited to legal fees and medical expenses) arising from and in connection with all HAZARDS and/or RISKS, whether occurring on or off the premises where the ACTIVITY takes place.

WILL BEAR the SOLE and EXCLUSIVE RESPONSIBILITY OF ANY HAZARDS AND/OR RISKS.

AND FURTHER AGREE that if despite this RELEASE AND WAIVER OF LIABILITY AGREEMENT the Member, or anyone on the Member’s behalf, makes a claim against any of the RELEASEES, The Member WILL IDEMNIFY, SAVE AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage or cost which may incur as a result of such claim.

KNOWING AND VOLUNTARY EXECUTION

Knowing and Voluntary Execution: REPRESENTS and WARRANTS to the GRACIE BARRA STAPLEHILL LTD that the Member through his/her guardian has acted prudently on the minor’s own behalf, and that his/her guardian possess all rights necessary to execute, deliver and perform this Agreement, and his/her guardian understands that this Agreement includes an assumption of the risk of negligence of the RELEASEES and a release of the liability of the RELEASEES to the MEMBER PARTIES.

The Member acknowledges and agrees that the GRACIE BARRA STAPLEHILL LTD is relying on this Agreement in allowing the Member to participate in the ACTIVITY.

NO LAWSUIT

No Lawsuit: REPRESENTS and WARRANTS to the RELEASEES that the Member shall not make or institute any lawsuit or claim any liability, in law or equity, against any of the RELEASEES with respects to the HAZARD and/or RISKS.

RELEASE OF LIKENESS RIGHTS

Release of Likeness Rights: GRANTS to the GRACIE BARRA STAPLEHILL LTD, its licensees, successors and ASSIGN, a non-exclusive, irrevocable licence to distribute, record, broadcast, exhibit, advertise and disseminate in perpetuity through the world the following elements: Member’s name, likeness, voice, biographical material, suggestions, stories about the Member, materials, including but not limited to photos and videos, ideas, and any actions performed by the Member or words spoken by the Member on or in connection with the ACTIVITY (hereinafter, Member’s Likeness) either in whole or in part, solely and exclusively.

ACKNOWLEDGES and AGREE that the GRACIE BARRA STAPLEHILL LTD will own all right, title and interest in any and all results and proceeds from use of the Member’s Likeness in any and all media now known or hereafter devised without compensation or benefits of any kind.

The GRACIE BARRA STAPLEHILL LTD is not obliged to actually use the Member’s Likeness.

NO REPRESENTATION OR WARRANTIES

No Representation or Warranties: NEITHER THE GRACIE BARRA STAPLEHILL LTD NOR ANY OF THE RELEASEES MAKES ANY REPRESENTATION OR WARRANTY, EXPRESS OR IMPLIED, WITH RESPECT TO THE ACTIVITY AND THE GRACIE BARRA STAPLEHILL LTD AND THE RELEASEES EXPRESSLY DISCLAIMS ALL EXPRESS OR IMPLIED REPRESENTATIONS AND WARRANTIES, INCLUDING BUT NOT LIMITED TO ANY IMPLIED WARRANTIES OF FITNESS FOR A PARTICULAR PURPOSE.

LIMITATION OF LIABILITY

Limitation of Liability: NOTHWITHSTANDING ANY PROVISION OF THIS AGREEMENT TO THE CONTRARY, THE GRACIE BARRA STAPLEHILL LTD AND OR NONE OF THE RELEASEES SHALL BE LIABLE TO THE MEMBER OR MEMBER’S PARTIES OR ANY OTHER PERSON OR ENTITY FOR ANY INDIRECT, SPECIAL, INCIDENTAL, CONSEQUENTIAL, PUNITIVE OR EXEMPLARY DAMAGES (INLCUDING BUT NOT LIMITED TO LOST REVENUES, ANTICIPATED REVENUES OR PROFITS), WHETHER IN AN ACTION IN CONTRACT OR TORT, UNDER STATUTE OR OTHERWISE, ARISING FROM ANY CLAIM DIRECTLY OR INDIRECTLY RELATING TO OR ARISING IN CONNECTION WITH THE ACTIVITY AND/OR THIS AGREEMENT.

SEVERABILITY

Severability: If any provision of this Agreement is founded to be invalid, unlawful or unenforceable to any extent, such provision shall be excluded from this Agreement, the remainder of which shall continue to be valid, lawful and enforceable in all other respects to the fullest extent permitted by law.

GOVERNING LAW

Governing Law: This Agreement shall be governed by and construed in accordance with the laws of the United Kingdom. Any controversy arising under this Agreement shall be adjudicated before the Bristol Crown Court as the court of competent jurisdiction.

By the execution and delivery of this Agreement, each party:

  1. accepts, generally and unconditionally, the exclusive jurisdiction of such court and any related appellate court; and
  2. irrevocably waives any objection it may now or hereafter have as to the venue of any such suit, action or proceeding brought in such a court or that such court is an inconvenient forum.

ENTIRE AGREEMENT

Entire Agreement: This Agreement constitutes the sole and entire understanding between the Member and the Academy with respect to the subject matter hereof and supersedes all prior agreements, promises, proposals, representations, understandings and negotiations, whether written or oral, between the Member and the Academy with respect to such subject matter.

MODIFICATIONS

Modifications: No amendment, supplement or modification to this Agreement shall be binding unless made in writing and signed by the parties hereto.

PARENT / GUARDIAN DECLARATION

I acknowledge that I have read the foregoing Agreement and I am familiar with each and all of the terms, covenants and conditions contained therein, I am satisfied that said agreement and release is fair and equitable, and I hereby give my express consent on behalf of the minor named below to the execution thereof and I agree I will not revoke my consent thereto at any time hereafter.

I hereby fully and unconditionally agree the performance of the below-named minor’s obligations and the grants of rights in and to said Member’s Likeness as set forth in the foregoing agreement and release.

I represent that I am the custodial parent or legal guardian of the minor named below, with the authority to grant such irrevocable consent and make all such guarantees.

IN WITNESS WHEREOF, the parties hereto have cause this Agreement to be duly executed as the date first written above.

    PARENT / GUARDIAN DETAILS

    CHILD DETAILS

    PARENT / GUARDIAN ACKNOWLEDGEMENTS

    Please answer Yes or No to each statement.

    I confirm that I have read and understood the Important Risk Notice. *

    I agree to the Terms and Conditions referred to in this waiver. *

    I confirm that I have read and understood the Parental Consent section. *

    I confirm that I have read and understood the Assumption of Risks section. *

    I confirm that I have read and understood the Release of Liability section. *

    I confirm that I have read and understood the Release of Likeness Rights section. *

    I confirm that I am authorised to give consent on behalf of the child named above. *

    CHILD COLLECTION / INDEPENDENT DEPARTURE


    I confirm that if I am not present to collect my child at the end of the session,
    I authorise my child to leave the club premises independently and accept
    responsibility for their journey and safety once they have left the premises.

    FINAL DECLARATION

    I confirm that I have read this Waiver and Release Agreement. *

    I confirm that I understand the agreement. *

    PARENT / GUARDIAN SIGNATURE

    Please draw your signature in the box below.