Princeton Brazilian Jiu Jitsu: Member Contract and Waiver
Student Information
Student Name: Date of Birth:
EFT Authorization:I, , authorize Princeton Brazilian Jiu Jitsu, to transfer electronic funds on a recurring basis from the checking, savings, or credit card account I specified above for my membership dues. This authorization is to remain effective until Princeton Brazilian Jiu Jitsu has collected for all charges assessed in connection with the terms and conditions of this Agreement.
Membership Term: I acknowledge and agree that I will maintain membership and pay the dues specified above for the term of membership . I agree that I will be liable for dues for the entire term of this agreement in the amounts as stated herein regardless of usage or any change of circumstance.
- Down Payment: I am making an initial down payment for the first month of membership..
- Next Payment: I understand my next payment for is due 30 days from the down payment and on the same day of each calendar month. Term has expired, this Agreement shall automatically continue from month to month at the prevailing membership rate, which is subject to change, until I contact Princeton Brazilian Jiu Jitsu in writing to cancel. I am responsible for all charges billed or incurred prior to cancellation. I further agree that my membership benefits are exclusive to me and are in no way transferable to anyone else.
Princeton Brazilian Jiu Jitsu agrees to provide and the Student, , agrees to purchase competent instruction, supervised by qualified personnel trained in the procedures and traditions of such activities.
The Student acknowledges and agrees as follows:
1. I have chosen to enter into the BJJ and/or Kickboxing programs.
2. Upon completion and full payment of any phase or program, students wishing to continue with the next phase or program must enter into a new Agreement.
3. Princeton Brazilian Jiu Jitsu or any party designated by Princeton Brazilian Jiu Jitsu may photograph or film me while I attend the premises of Princeton Brazilian Jiu Jitsu and use of any and all such photos, video footage and/or video streaming for promotion, sales, publicity and advertising purposes for all media, including, but not limited to, the internet.
4. The required physical exertion may be strenuous and cause physical injury, and I am fully aware of the risks and hazards involved. I hereby represent that I am physically fit to receive and participate in the prescribed course of instruction. I acknowledge that I have been advised to consult with a physician prior to and regarding my participation in the Classes and that my physician has confirmed to me that I have no medical condition which would affect my full participation in the Classes.
5. In consideration of my being permitted to participate in the Classes, I for myself, my heirs, executors, administrators, successors, assigns and anyone else who may claim on my behalf hereby waive any and all claims, liability and damages I may now or in the future have against Princeton Brazilian Jiu Jitsu, its directors, officers, instructors and staff and all persons acting under its authority and their respective heirs, executors, administrators, successors, and assigns, arising by any means whatsoever, including, but not limited to death, injury, damages to or loss to my person or property of any kind whatsoever, no matter how caused arising from or in connection with my participation in the Classes, however caused.
6. I further hereby release, remiss and forever discharge Princeton Brazilian Jiu Jitsu, its directors, officers, instructors and staff and all persons acting under its authority and their respective heirs, executors, administrators, successors, and assigns from and against all demands, claims, actions, damages, costs and expenses arising from or with respect to death, injury, damages to or loss to my person or property of any kind whatsoever, no matter how caused, arising from or in connection with my participation in the Classes whether or not caused by, in whole or in part, the negligence or gross negligence of Princeton Brazilian Jiu Jitsu.
7. I will hold harmless and indemnify Princeton Brazilian Jiu Jitsu, its directors,officers, instructors and staff and all persons acting under its authority and their respective heirs, executors, administrators, successors, and assigns from any and all liability for any damage or injury to the property or persons of any third party resulting from my involvement in or presence during any of the Classes.
8. I will comply with all the rules and regulations of Princeton Brazilian Jiu Jitsu.
9. I will pay a service charge of $20.00 for any payments 10 days past due. If there are three payments which are 10 days past due during the period of this Agreement, I agree to pay the remaining balance of the Agreement in full, in addition to any and all recovery charges incurred.
10. I hereby agree that if Princeton Brazilian Jiu Jitsu, is unable to process my payment from the designated account provided by me Princeton Brazilian Jiu Jitsu is permitted to use any of the other accounts information provided as many times and as often as needed to replace the unpaid payments and service charges as explained on section 9 of this agreement.
11. In addition to any rights and remedies it may otherwise have, Princeton Brazilian Jiu Jitsu may terminate this Agreement upon ten days' written notice to me if I fail to comply with my obligations under this Agreement and do not cure any such failure within ten days after receiving notice of such failure.
12. Failure to attend the Classes does not relieve me of the obligation to pay the full tuition for the program or phase in which I am currently enrolled.
13. I confirm that the provisions in this Agreement constitute the entire agreement between the parties hereto and supersede all prior communications, proposals, representations and agreements, whether oral or written with respect to the subject matter of this Agreement.
14. Princeton Brazilian Jiu Jitsu is committed to protecting the privacy of personal of our customers. We make every effort to ensure that the information you share with us is recorded accurately, retained securely and used only according to your wishes. We collect personal details necessary to communicate with you, and manage our ongoing business relationship with you. If you have any questions about how your personal information is handled or distributed, or if you wish to receive a full copy of our full privacy policy, please contact our privacy officer.
15. I acknowledge receiving a copy of this Agreement.
16. I understand my rights and obligations as stated above. I confirm that I am the full age of nineteen years (unless otherwise indicated below) and that I have read and understood this release and waiver of liability and I am aware that by signing this Agreement I am waiving certain legal rights, including the right to claim damages which I or my heirs, executors, administrators, successors or assigns my have against Princeton Brazilian Jiu Jitsu.
17. Right of cancellation: Please refer to separate updated cancellation policy.
In witness whereof, I have executed this release and the above terms, as of today.
AGREEMENT
Princeton Brazilian Jiu Jitsu (PBJJ) 741, Unit 4, Princeton, New Jersey 08540 www.princetonbjj.com
This is important, and I have had enough time to read it carefully and understand it before signing.
I UNDERSTAND WHY I AM SIGNING THIS AGREEMENT
I am an adult over 18 years of age and wish to participate in or wish for my child to participate in Princeton Brazilian Jiu Jitsu and its affiliates (abbreviated as “PBJJ” below) activities. By reading and signing this agreement, it is clear to me that I am waiving, or giving up, certain rights that I might have in the event I, or my child, is injured. Still, I am signing this waiver voluntarily because I am willing to accept and assume the risk of injuries in order to participate in these activities. At its most basic, I am giving up my rights, or the rights or anyone on my behalf or that are derived from my rights, to make any claims, hire any lawyers, bring any law suits, or collect any money for any injuries or damages that may occur to me or to my minor children if they participate, in any PBJJ activities.
I UNDERSTAND WHAT SIGNING THIS MEANS
I understand and acknowledge that by signing this agreement I release PBJJ and its owners, instructors, staff members, and agents from any and all liability, or legal responsibility, for any injury, illness, loss, or damage connected in any way whatsoever to my own or my child(ren)’s participation in PBJJ activities, whether on or off the PBJJ premises. Whether I am brand new to combat sports or I am very experienced, I understand that even when every reasonable precaution is taken, accidents can sometimes still happen. And I understand that even minor accidents in combat sports can result in sometimes very serious injuries. I know it is impossible to list every risk that might occur, but I know that aside from all the musculoskeletal and central nervous system injuries that are somewhat common in combat sports, some of the risks include having contact with individuals that have been exposed to and/or have been diagnosed with one or more communicable diseases. This includes but is not limited to COVID-19 or other medical conditions, diseases, or maladies, and it is impossible to eliminate the risk that I could be exposed to and/or become infected through contact with, or close proximity to, an individual with a communicable disease.
I UNDERSTAND WHO THIS AGREEMENT COVERS
I understand that this release includes any claims based on negligence, action or inaction, of the PBJJ, its owners, instructors, staff members, and agents, including directors, members, volunteers, and guests.
Once I sign this agreement, I understand that it will prevent not only myself, but my children, heirs, executors, and administrators from ever making any claims or exercising any rights in any way for any damages that might occur through participating in any PBJJ activities. Signing this means I waive, release, and forever discharge any and all rights and claims for damages involving PBJJ in any way.
I UNDERSTAND THESE ACTIVITIES AND RISKS AND PROMISE TO MAKE SAFETY A PRIORITY
I understand I am responsible for monitoring my own condition and should any unusual symptoms occur, I will cease my participation and inform the instructor of the symptoms. I also understand that everyone’s comfort level and tolerance for discomfort is different, and some vastly so. I know that I am responsible for my safety and the safety of others in PBJJ, and that at any point, regardless of the situation, I will always consider my safety and that of the others in PBJJ. I will alert my instructors or the staff if I perceive any situation as beyond my capacity to exercise safe and controlled behavior. Nevertheless, I also understand that in combat sports accidents may happen very fast, and I knowingly and voluntarily accept these risks.
KNOWING ALL THIS, I STILL WANT TO ASSUME THESE RISKS AND
PARTICIPATE
By signing, I affirm I understand the nature of the programs and agree to assume all associated risks. I am voluntarily signing this authorization and release. No one is making me sign this, forcing me to participate in these activities, or making promises to me about this agreement that are not written here. I understand what it says and means. I have read this form and grant permission for each child listed to participate in any and all activities provided by Princeton Brazilian Jiu Jitsu and its affiliates.
*If under 18 years of age, a parent or guardian signature is required