I understand and have had explained to me that the martial art known as “Gracie Jiu-Jitsu is taught using all precautions to avoid any injuries.  However, it may entail some risk of accident or injury and that this may be serious or even mortal as a consequence of the practice of the before mentioned “Gracie Jiu-Jitsu.”

I understand and have had explained to me that, along with the possibility of personal injury, injury to property is also possible, such as, but not limited to possible loss of wages and the ability to earn such wages. 

With full knowledge of the aforementioned dangers, both to my person and to my property (current and future), and after having these dangers fully explained to myself and/or to my legal guardian.

I hereby certify and declare that I will release and forever hold free and discharge from any liability Brajitsu, Inc., dba Gracie Jiu-Jitsu Academy, Gracie Durham Inc. dba Gracie Durham and each of their agents, stockholders, directors, officers, employees and representatives of and from all claims, demands, rights and causes of action of any nature whatsoever which may have or which may hereafter accrue to me, arising from and by reason of any and all bodily or personal injury, damage to property or other loss and any consequence thereof, whether known or unknown, seen or unforeseen, resulting from my participation in Gracie Jiu-Jitsu, their persons and entities mentioned above.

Further, knowing and understanding these risks, nevertheless I hereby agree to voluntarily assume these risks and to release and hold harmless all the persons or entities mentioned above whom might otherwise be liable to me for damages.  It is further understood that this waiver, release and assumption of risk is forever binding on my heirs and assigns.  I also understand and acknowledge that I have and will maintain appropriate medical insurance during classes/training.

I am also aware that for purposes of safety, security and quality control there may be surveillance cameras mounted throughout Gracie Durham.  I hereby grant Brajitsu, Inc.  DBA Gracie Jiu-Jitsu Academy and, Gracie Durham Inc. dba Gracie Durham the unlimited use of my likeness in any format video/DVD for promotional advertisement or commercial use in any format know or yet to be developed in perpetuity and I forfeit any form of payment.  It is further understood that I will not film any classes/training without prior permission from the Gracie Academy and/or Gracie Durham.

My signature on this document is evidence that I know and understand and have had this document explained to me, that I fully understand the dangers that are inherent in this martial art and that I voluntarily certify that I will not hold Brajitsu, Inc., d.b.a. Gracie Jiu-Jitsu Academy, Rorion Gracie, the Gracie family, Gracie Durham Inc. dba Gracie Durham their agents and/or assigns, responsible for any injury whether as a result of training or not.  In addition, I agree to the policies applied for all students of Gracie Durham presented at the time of registration and future changes implemented.

 Durham, NC   info@GracieJiuJitsuDurham.com   919.964.5777