Full Name: {name}
Date of Birth: {dob}
Address: {address}
Phone: {phone}
Emergency Contact:
{contact_name}
{contact_phone}
{contact_relation}
Rules and Regulations:
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I am in good health and have no mental or physical disability, impairment, medical condition, illness or health related issue which may prevent me from engaging in exercise or using Renzo Gracie El Paso’s facilities or which poses a health risk to myself or to other members/staff. I assume full and complete responsibility for my medical conditions as it relates to my participation at Renzo Gracie El Paso. I have consulted with a medical physician, and I have not been instructed by such physician to avoid or refrain from participation in any activities of the type available at Renzo Gracie El Paso. INITIALS:
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I understand that my participation at Renzo Gracie El Paso involves some risk. I hereby knowingly, intelligently and voluntarily assume ALL risk and responsibility for any and ALL damage to property and/or bodily and/or personal injury, including death, in connection with my participation at Renzo Gracie El Paso. INITIALS:
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Renzo Gracie El Paso has advised me not to bring valuable personal property into the gym. I assume full responsibility for any loss or damage to my personal property, which may occur. Renzo Gracie El Paso and it's staff shall not be liable for the loss, theft or damage to any personal property located anywhere on the premises. Renzo Gracie El Paso may repair, at my expense, any damage caused by me to its facility or its property. I agree to pay on demand any amounts expended. INITIALS:
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I agree to keep and obey all rules and regulations now in force or in the future prescribed by Renzo Gracie El Paso for the use of all the gym’s training facilities, premises and equipment. Renzo Gracie El Paso reserves the right to revoke this membership if the member fails to keep and obey any such rules and regulations, or for reasons of moral turpitude, fraud or nuisance or disturbance to other members or staff. INITIALS:
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Renzo Gracie El Paso has the right to alter the days, hours of operation and classes if deemed necessary to better fit the student’s needs. INITIALS:
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I agree to grant Renzo Gracie El Paso, it’s representatives, and employees the right to take photographs of me and my property in connection with the above-identified membership. I authorize Renzo Gracie El Paso to copyright, use and publish the same in print and/or electronically. I agree that Renzo Gracie El Paso may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content. INITIALS:
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In the event that any part of this Release, Agreement and Waiver is held to be illegal, invalid or unenforceable, it is the express intention of the parties that the remainder of this Release, Agreement and Waiver or the application of such terms, clauses or provision other than to those as to which it is held illegal, invalid or unenforceable, shall not be affected thereby, and each term, clause or provision of this Release, Agreement and Waiver and the application thereof, shall be legal, valid and enforceable to the fullest extent permitted by law. INITIALS:
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I understand that if I wish to place my membership with Renzo Gracie El Paso on hold for any reason which prevents me from participating, a request must be made via email or in person at the front desk with one of the Program Directors. I understand that my payment will resume effective immediately on my return date. INITIALS:
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I understand that if I wish to cancel my membership with Renzo Gracie El Paso I must give 30 day notice to cancel any membership. This notice must be submitted in person or via email to ensure proper processing. During this 30-day period, any scheduled dues will continue to be withdrawn and members are welcome to continue training during this time. I agree that I am subject to pay the next scheduled transaction If I fail to provide notice before the scheduled billing day, and am able to train throughout that final month. INITIALS:
ACKNOWLEDGEMENT OF RISK AND WAIVER OF LIABILITY
The Renzo Gracie El Paso Academy, hereinafter referred to as “Renzo Gracie El Paso”, shall not assume responsibility or be held liable for any injury to person or damage or loss of property suffered by any member or any guest. The undersigned is familiar with the risks inherent in participating in gym activities conducted in Renzo Gracie El Paso’s facilities. The undersigned is aware that Renzo Gracie El Paso offers, at its own discretion and at different times, such activities including, but not limited to, as Brazilian Jiu-Jitsu, Mixed Martial Arts, Muay Thai, Boxing, Wrestling, Cross-Training, Cardio-Kickboxing, Weight Training, Yoga, etc. Further, the undersigned is aware of all the risks of personal injury to himself when undertaking such combat activities. The undersigned knowingly, voluntarily, willingly, intentionally, intelligently and without any force or coercion while not under the influence of any medications, drugs or alcohol that would compromise his thinking or ability to understand this entire document, enters this Release and Waiver with all of its terms and conditions. The undersigned assumes all risks of any and all injury-causing events that are known, apparent or reasonably foreseeable consequences of participation. The undersigned hereby acknowledges that Renzo Gracie El Paso has exercised all reasonable care to protect the undersigned from unassumed, concealed or unreasonably increased risks, including, but not limited to any of the aforementioned which are related to Covid-19 or any other pandemic, disease or any and all types of a force majeure, unforeseeable events or circumstances outside the control of Renzo Gracie El Paso including, but not limited to, riots, strikes, wars, crimes, weather conditions or epidemics which render the performance of Renzo Gracie El Paso impossible or impractical. Therefore, in consideration for being permitted to become a member or guest of Renzo Gracie El Paso, the undersigned hereby knowingly, intelligently, voluntarily and without any force, threats or coercion, assumes any and all risks of personal injury, property damage and or other damages to the undersigned resulting from, or in any way associated with his entry into RGA’s facilities and or participation in any of the activities offered by Renzo Gracie El Paso. Further, the undersigned hereby releases Renzo Gracie El Paso and its agents, instructors, professors, employees, staff and all other personnel from every claim, liability and damage of any kind or on account of any personal injury, property damage, or other damages resulting from or in any way associated with the undersigned’s entry upon Renzo Gracie El Paso’s premises and or participation in any of Renzo Gracie El Paso’s activities THE UNDERSIGNED CONFIRMS THAT HE HAS READ AND UNDERSTOOD THIS RELEASE AND WAIVER AND HAS WAIVED HIS RIGHT TO HAVE ANY ATTORNEY REVIEW THIS ENTIRE DOCUMENT PRIOR TO SIGNING.
Welcome to the Renzo Gracie Brazilian Jiu Jitsu Academy!