Waiver Form

    I assume all risks or incidents to my presence (or the presence of listed minor) at MEBJJ, LLC d/b/a Mario Queiroga BJJ club and use of the club facilities, including instruction and training. Risks include but are not limited to: bodily injury; misuse or failure of club equipment or facilities; bodily injury due to over training; improper training or other actions that may exacerbate a known, unknown or hidden health condition; bodily injury due to the acts or omissions of others; bodily injury due to dehydration, overheating, or other physical conditions. I understand that the clubs officers, employees and other agents undertake no responsibility to become aware at any time of a participant’s health conditions, fitness, abilities, overexertion, or other conditions and conduct that may increase inherent risks from participation in club activities. I agree to hold harmless and indemnify MEBJJ, LLC and all of its owners, management, agents, instructors, staff and employees from and against any and all lawsuits, actions, losses, damages, claims, or liability of any kind, nature, character, type or description, including without limiting the generality of the foregoing all expenses of litigations, court costs, and attorney’s fees for injury and/or death to myself, or the minor I am representing, out of or connected in any manner with myself, or the minor’s presence, at the club or use of its facilities, instruction, training, including but not limited to such actions, losses, damages, claims or liability arising from the negligence or alleged negligence of MEBJJ, LLC and its staff and members.

    For Minors:
    I am the legal guardian of , a minor or person otherwise legally incompetent or incapacitated. I have requested that the club make its facilities, instruction and training available to the minor and in consideration of such and as a condition of permitting the minor access to the clubs facilities instruction and training, I hereby agree, on behalf of myself, my heirs, assigns all persons who may have the right to make any claim by me or through me as stated above in the waiver section of the Agreement.

    MEBJJ, LLC reserves the right to use your image and or likeness for promotional purposes, including, but not limited to: photographs,
    images, and videos.

    Your Info:

    Mailing Address:


    Minor's Info (If Applicable):

    Where Did You Hear About Us From?

    I have read the release, fully understand it, and agree to be legally bound by it.