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Kids Jiu Jitsu Membership Waiver

Before setting up a Kids Jiu Jitsu membership, a parent or legal guardian must complete this waiver form for the child participant. After submitting the form, you will be sent to Square to complete the membership payment.

Participant Date of Birth
Year
Month
Day

PARTICIPANT AGREEMENT, WAIVER & RELEASE OF LIABILITY

MicBeth Holdings Inc. o/a The Chop Shop  |  175 Industrial Park Rd, Unit A, Haliburton, ON  K0M 1S0

Assumption of Risk & Release of Liability

Training at The Chop Shop includes Brazilian Jiu Jitsu, fitness kickboxing, grappling, drilling, sparring, and physical conditioning. These activities involve close physical contact, equipment use, and movement on padded and non-padded surfaces.

I understand that participation involves inherent risks, including but not limited to:

  • bruises, cuts, and soreness

  • sprains, strains, and joint injuries

  • concussions or head injuries

  • fractures or broken bones

  • serious injury, permanent disability, or death

  • exposure to illness or communicable conditions

I understand these risks may arise from my own actions, the actions or negligence of others, equipment failure, or facility conditions.

I knowingly and voluntarily accept and assume all risks, both known and unknown.

IN CONSIDERATION FOR BEING PERMITTED TO PARTICIPATE, I HEREBY RELEASE, WAIVE, AND FOREVER DISCHARGE MICBETH HOLDINGS INC. O/A THE CHOP SHOP AND ITS OWNERS, DIRECTORS, OFFICERS, EMPLOYEES, INSTRUCTORS, COACHES, VOLUNTEERS, MEMBERS, LANDLORDS, AND AGENTS (THE “RELEASED PARTIES”) FROM ANY AND ALL CLAIMS, DEMANDS, DAMAGES, LOSSES, OR CAUSES OF ACTION OF ANY KIND WHATSOEVER, INCLUDING THOSE ARISING FROM THE NEGLIGENCE OF THE RELEASED PARTIES THEMSELVES, BREACH OF STATUTORY DUTY, OR FAILURE TO EXERCISE REASONABLE CARE, TO THE FULLEST EXTENT PERMITTED BY THE LAWS OF ONTARIO.

I further agree to indemnify and hold harmless the Released Parties from any claims, damages, liabilities, or expenses (including legal fees) arising from my own actions, negligence, or failure to comply with the rules and instructions of The Chop Shop.


3.  Physical Contact Acknowledgement

I understand that martial arts training involves close physical contact, including grappling, positional control, and controlled striking. I acknowledge that I may withdraw from any activity at any time, and I am responsible for communicating if I feel unsafe or uncomfortable.


4.  Health, Conduct & Medical Consent

I confirm that I am physically able to participate in martial arts training, have not been advised by a physician to refrain from such activity, and have no condition that would make participation unsafe.

I agree to: inform instructors of any injuries or medical conditions; follow all instructions; train within my abilities; respect all safety rules (including tapping or stopping when required); and conduct myself safely and respectfully. I understand that unsafe or inappropriate behaviour may result in removal from training.

I authorize The Chop Shop and its staff to provide or arrange emergency medical treatment if deemed necessary. I am responsible for any medical costs incurred, and The Chop Shop is not responsible for the outcome of any medical care provided.


5.  Photography & Media Notice

The Chop Shop may photograph or record training sessions, classes, or events for promotional, educational, or community purposes, including use on its website and social media platforms.

If I do not wish for my image or likeness to be used, I understand that it is my responsibility to notify The Chop Shop in writing or inform an instructor or staff member.

I understand that The Chop Shop will make reasonable efforts to respect such requests.


6.  Parent / Guardian Agreement (If Participant Is Under 18)

I am the parent or legal guardian of the participant named above. I consent to their participation, accept and assume all risks on their behalf, and agree to all terms of this agreement. I further agree to indemnify and hold harmless the Released Parties from any claims brought on behalf of the minor, to the extent permitted by law.


7.  Legal Terms

This agreement is governed by the laws of the Province of Ontario and the laws of Canada applicable therein. If any provision is found invalid or unenforceable, the remaining provisions remain in full force. This document constitutes the entire agreement between the parties and supersedes any prior discussions or representations. I acknowledge that I am not relying on any verbal statements or assurances regarding safety or risk made by The Chop Shop or its staff.


8.  Acknowledgement & Signatures

I acknowledge that this agreement limits my legal rights, including my right to sue, and that I am giving up substantial legal rights by signing it. I confirm that I have read and understood this agreement, have had the opportunity to ask questions and seek independent legal advice, and am signing freely and voluntarily as a legally binding agreement.

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