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SHIELD BRAZILIAN JIUJITSU

ACKNOWLEDGEMENT AND RELEASE FORM (WAIVER OF LIABILITY)

COVID-19 Supplement

This is a supplement to our standard waiver of liability to include special COVID-19 related items.

1. The undersigned acknowledges that the disease caused by the novel coronavirus (COVID-19) has been confirmed throughout the United States.  In accordance with the most recent guidance and protocols issued by the Centers for Disease Control and Prevention (CDC) and the state Department of Health for slowing the transmission of COVID-19, the undersigned hereby agrees, represents, and warrants that neither the undersigned nor such participating children shall visit or utilize the facilities, services, and programs (other than any online services) within 14 days after (i) returning from a highly impacted area subject to CDC Level 3 Travel Health Notices, (ii) exposure to any person returning from areas subject to a CDC Level 3 Travel Health Notice, or (iii) exposure to any person who has a suspected or confirmed case of COVID-19.  The complete CDC Travel Health Notice is continuously updated at https://www.cdc.gov/coronavirus/2019-ncov/travelers/map-and-travel-notices.html and the undersigned agrees that they are aware of this list and the countries listed.
2. The undersigned hereby agrees, represents, and warrants that neither the undersigned nor such participating children shall visit or utilize the facilities, services, and programs (other than any online services) if he or she (i) experiences symptoms of COVID-19, including cough, shortness of breath or difficulty breathing, fever, or new loss of taste or smell, or (ii) has a suspected or diagnosed/confirmed case of COVID-19.  The undersigned agrees to notify us immediately if he or she believes that any of the foregoing access/use restrictions may apply.
3. We have taken certain steps to implement recommended guidance and protocols for slowing the transmission of COVID-19, including, without limitation, the access/use restrictions set forth above.  The undersigned acknowledges and agrees that we may revise those procedures at any time based on updated guidance and protocols and further agrees to comply with the revised procedures prior to utilizing our facilities, services, or programs (other than any online services).

In further consideration of being permitted to enter our facility for any purpose including, but not limited to, observation or use of facilities or equipment, or participation in any on-site program, the undersigned hereby agrees to the following:

1. The undersigned, on his or her behalf, and on the behalf of such participating children, hereby releases, waives, discharges, and covenants not to sue SHIELD BRAZILIAN JIUJITSU  , its directors, officers, employees, volunteers and agents from all liability to the undersigned or such participating children for any loss or damage, and any claim or demands on account of any property damage or any injury to, or an illness or the death  of, the  undersigned or such participating children (or any person who may contact COVID-19, directly or indirectly, from the undersigned or such participating children) whether caused by negligence, active or passive, of SHIELD BRAZILIAN JIUJITSU or otherwise while the undersigned or such participating children are in, upon, or about the premises. 
2. The undersigned hereby agrees to indemnify and save and hold harmless SHIELD BRAZILIAN JIUJITSU, its directors, officers, employees, volunteers and agenda, and each of them, from any loss, liability, damages or costs they may incur, whether caused by the negligence, active or passive, or otherwise while the undersigned or any participating child is in, upon, or about the premises of SHIELD BRAZILIAN JIUJITSU 

I HAVE CAREFULLY READ AND VOLUNTARILY SIGN THIS ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT AND FURTHER AGREE THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENT APART FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE.  I AM AWARE THAT BY AGREEING TO THIS AGREEMENT, I AM GIVING UP VALUABLE LEGAL RIGHTS, INCLUDING THE RIGHT TO RECOVER DAMAGES FROM SHIELD BRAZILIAN JIUJITSU IN CASE OF ILLNESS, INJURY, DEATH OR PROPERTY LOSS OR DAMAGE, INCLUDING, FOR THE AVOIDANCE OF DOUBT AND WITHOUT LIMITATION, EXPOSURE TO COVID-19 AND ANY ILLNESS, INJURY, OR DEATH RESULTING THEREFROM.  I UNDERSTAND THAT THIS DOCUMENT IS A PROMISE NOT TO SUE AND A RELEASE OF AND INDEMNIFICATION FOR ALL CLAIMS.  IF SIGNING ON BEHALF OF A MINOR, I ALSO UNDERSTAND THAT THIS AGREEMENT IS MADE ON BEHALF OF MY MINOR CHILD(REN) AND/OR LEGAL WARDS AND I REPRESENT AND WARRANT THAT I HAVE FULL AUTHORITY TO SIGN THIS AGREEMENT ON BEHALF OF SUCH MINOR(S).

SHIELD BRAZILIAN JIUJITSU

WAIVER AND RELEASE OF LIABILITY

The student understands that jiu-jitsu and all martial arts are sports that involve physical contact. You, Buyer, and/or Student hereby waive and release any claim or right to sue Johnny Martens and Shield Brazilian Jiujitsu and any instructors, employees, volunteers, management and or teammates at the facility in Leland NC, or any other facility owned by johnny Martens. that may occur on or off the premises, through negligence or not, while participating, practicing, or competing in Jiu-Jitsu, or any other martial arts program. The student understands that the agreement to use, or selection of exercise programs, methods, and types of equipment shall be the student’s entire responsibility, and the School shall not be liable to the student for any claims, demands, or actions arising due injury to the student’s person or property arising out of or in connection with the use by a student of the services, facilities, and premises of the School.

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