Please fill out the form below to register for a complimentary BJJ class. Participant * for an adult for a child CONTACT INFORMATION * First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country How did you hear about us? * Gender Male Female Terms and Conditions: * Waiver and Release of Liability: Dracxler Jiu Jitsu Express Assumption of risk: I, the undersigned, am aware that there are significant risks involved in all aspects of physical training. These risks, included, but are not limited to: falls which can result in serious injury or death, injury or death due to negligence on the part of myself, my training partner, or other people around me, and injury or death due to improper use or failure of equipment. I am aware that any of these above mentioned risks may result in serious injury or death to myself and/or my partners. I willing assume full responsibility for the risks that I am exposing myself to and accept full responsibility for any injury or death that may result from participation in any activity or class while at Dracxler Jiu Jitsu. I, the undersigned acknowledge that I have no physical impairments or illnesses that will endanger others or myself. Release: In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willingly and voluntarily participating in the activities at Dracxler Jiu Jitsu, I hereby release DracxlerBJJ, their principals, agents, employees, and volunteers from any and all liability, claims, demands, actions or rights of actions, which are related to, arise out of, or are inane way connected with my participation in these activities, including those allegedly attributed to the negligent acts or omissions of the above mentioned parties. This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, and transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect. If I am signing on behalf of a minor child, I also give full permission for any person connected with DracxlerBJJ to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical and or surgical care for the child and to transport the child to a medical facility deemed necessary for the well being of the child. Any video/photographic documentation taken while participating in any program, recreational activity or event are property of DracxlerBJJ and may be used by DracxlerBJJ at their discretion. In consideration for being allowed to participate in DracxlerBJJ exercise programs, I agree to assume the risk of such exercises, and further agree to hold harmless DracxlerBJJ and its staff members from any and all claims, suits, losses, or related causes of action for damages, including, but not limited to, such claims that may result from my injury or death, accidental or otherwise, during or arising in any way from, the exercise programs. I understand that by signing this form I am waiving valuable legal rights. Anyone age 17 and under must be accompanied by a parent or their legal guardian on their first visit. Appointments are required. I have read and agree to the Terms and Conditions Thank you! REQUIREMENTS and EXPECTATIONS:Please come 5-10 minutes earlier before the class starts.When dressing for BJJ, choose comfy clothes like shorts or leggings and a t-shirt or rash guard.We will provide you with a clean gi to use for your introductory classShoes are prohibited on the mat but are mandatory everywhere else in the dojo.