PLANNING ON COMING IN? SAVE SOME TIME BY FILLING OUT OUR WAIVER ONLINE: Step 1 of 2 50% INSIGHT BJJ Release and Waiver of Liability and Indemnity AgreementIn consideration of being permitted to participate in any way in at Insight BJJ and/or being permitted to enter for any purpose any restricted area (here in defined as any area where in admittance to the general public is prohibited), I [individually and/or as the parent / legal guardian of the child(ren)] identified below] agree and acknowledge: The parent(s) and/or legal guardians will instruct the minor participant that prior to participating in the below Martial Arts activity or event, he or she should inspect the facilities and equipment to be used, and if he or she believes anything is unsafe, the participant should immediately advise the Insight BJJ of such condition and refuse to participate. I understand and agree that, if at any time, I feel anything to be unsafe; I will immediately take all precautions to avoid the unsafe area and REFUSE TO PARTICIPATE further and will report the unsafe condition immediately to Insight BJJ. I understand, agree, accept, and assume the risk of the following: There are risks and dangers associated with participation in Martial Arts events and activities which could result in bodily injury partial and/or total disability, paralysis and death; The social and economic losses and/or damages, which could result from these risks and dangers described above, could be severe; These risks and dangers may be caused by the action, inaction or negligence of the participant (me or my child) or the action, inaction or negligence of others; and There may be other risks not known to me or are not reasonably foreseeable at this time. I HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE Insight BJJ (Alex Henley), including its owners, instructors, managers, promoters, lessor of the premises, and/or other students from all liability to me or my child, including but not limited to my assigns, executors, heirs and next of kin. This release includes but is not limited to any and all claims, demands, losses or damages related to any injury sustained while at Insight BJJ’s studio or while training BJJ whether or not at Insight BJJ’s studio, including but not limited to the death of the participant or damage to property. I HEREBY acknowledge that THE ACTIVITIES OF THE EVENTS(S) ARE VERY DANGEROUS and involve the risk of serious injury and/or death and/or property damage. Each of THE UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASE BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE UNDERSIGNED. EACH OF THE UNDERSIGNED further expressly agrees that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the State of Texas and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding continue in full legal force and effect. I [individually and/or as the parent / legal guardian of the child(ren) identified below] execute this Waiver and Release. If, despite agreeing to the term herein, a claim is made by me or on my behalf against any of the released party described above, I agree to indemnify and/or reimburse such party for any attorneys’ fees and/or money they have had to expend and/or incur related to the claim. I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT AND INDUCEMENT, ASSURANCE OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW. I have read and agree to the terms of this Waiver of Liability Agreement* Yes NO SHOES ON THE MAT Watch your language No jewelry on the mat Arrive on time If you have a reason why you must be regularly late, please discuss with instructor ahead of time Respect your training partners No bragging on the mats Good Hygiene, including: Wash your gis/rashguards (not your belt) Keep finger/toenails trimmed Beware of bad breath Stay home of you are sick Pay attention during technique Work only on the techniques being taught Shake the hand of any black belt Be a positive representative of the school Also see our 10 minute Intro to Gym Rules video I have read and agree to abide by the rules of the gym.* Yes We use photos & videos of our facility for advertising, promotional events, Facebook, Twitter, promotional DVDs and our website. Our members and their family members may be captured in these photos & videos. We are requesting your permission to use photos & videos that could contain you or your child for the previously mentioned reasons.* Yes By checking this box you give permission: Personal InformationIs this waiver is for a minor?YesNoParticipant Name* First Last Name of Minor* First Last Name of Parent / Guardian* First Last Signature* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Your Photo (optional)Re-type this code below Get our rates sent immediately to your email, then come in for your FREE WEEK! Your Name*Phone*Email* Interest(s)? Adult Jiu Jitsu / Judo Adult No Gi Self Defense Kids Jiu Jitsu / Judo / Self Defense GOOD NEWS! Jiu Jitsu and Self-Defense are synonymous. By training at Insight BJJ you will naturally start to build up your self-defense abilities!Belt Level (Adult)--No ExperienceWhite BeltBlue BeltPurple BeltBrown BeltBlack BeltNo Gi Experience (Adult)--No ExperienceBeginner (0-1 years)Intermediate (1-3 years)Advanced (3-5 years)Expert (5+)Belt Level (Kids)--White Belt / BeginnerGray BeltYellow BeltOrange BeltGreen BeltAge of Child(ren)Preferred class times Lunch Time Evening Comments (Welcome, but not required) How did you hear about us?*--FacebookGoogleDrove ByFriendPrint / NewspaperOtherCare to give your friend's name?If other:Join Mailing List?*YesNoWould you like a phone call to learn more about our program?*YesNoPreferred contact time9am - NoonNoon - 1pm1pm - 5pmRe-type this code belowEmailThis field is for validation purposes and should be left unchanged.