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Waiver Form

I, {name}, wish to participate in training and receive instruction in the art of the service provided to me by Edenilson Roberto Siqueira de Lima. In consideration of the service provided to me by Edenilson Roberto Siqueira de Lima, I hereby freely and knowingly accept and agree to the following terms and conditions.

Assumption of Risk: I understanding that Jiu-Jitsu is a hazardous activity that involves inherent
risk of serious physical injury. With full knowledge of risks involved in Jiu-Jitsu, I expressly assume all the risk of harm to myself arising from the practice of Jiu-Jitsu with Edenilson Roberto Siqueira de Lima.

Release of Claims and Waiver of Liability: I hereby expressly and for all times, on behalf of
myself, my heirs, successors and assigns, executors and personal representatives release and agree to hold harmless Edenilson Roberto Siqueira de Lima from any claim, demand or cause of action at law or equity from any injury to me that arises or might have
arisen from my participation in the practice of Jiu-Jitsu, from my use of the equipment of the DJJC TEAM LLC or from my participation in any activity associated directly or indirectly with DJJC TEAM LLC, or from any use of Jiu-Jitsu techniques.

 Indemnification: I hereby agree to indemnify and hold harmless Edenilson Roberto Siqueira de Lima from any claim, demand or cause of action at law or equity, including but not limited to, any claim of personal injury, that may be asserted against Edenilson Roberto Siqueira de Lima by any third party as a direct or indirect result of my participation in the practice of Jiu-Jitsu, from my use of the equipment of the DJJC TEAM LLC, from my participation in any activity directly or indirectly associated with the DJJC TEAM LLC, or from my use of Jiu-Jitsu techniques.

Definition: As use in this agreement, the terms “Edenilson Roberto Siqueira de Lima” and “DJJC TEAM LLC” include Edenilson Roberto Siqueira de Lima, the DJJC TEAM LLC, and any heir, successor, assign executor, employee, member, representative, assistant instructor, owner or director of any or all of them.

Photo Release: I hereby grant DJJC TEAM LLC permission to use my likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration. I understand and agree that all photos will become the property of DJJC TEAM LLC and will not be returned. I hereby irrevocably authorize DJJC TEAM LLC to edit, alter, copy, exhibit, publish, or dis- tribute these photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo. I hereby hold harmless, release, and forever discharge DJJC TEAM LLC from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

I HAVE READ THIS ENTIRE DOCUMENT. I UNDERSTAND AND AGREE TO ITS TERMS

Student name if minor for adult type N/A

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