Copperhead Pendleton

Copperhead Jiu Jitsu Member

Member Details

* Required field
Add secondary Phone +
Change Email address
A member account already exists with this Email address. Log-in instead?
Add secondary Email +


Address

Contacts

Additional Contact

Photo

Edit Photo

Delete Photo Apply
Capture from camera No camera found. Please connect a camera to use this feature. Upload or use camera Upload photo

Waiver / liability release

Waiver of Liability and Photo Release 

I hereby understand and acknowledge that the training, programs and events held by Copperhead Jiu Jitsu may expose me to many inherent risks, including accidents, injury, illness, or even death. I assume all risk of injuries associated with participation including but not limited to falls, contact with other participants, the effects of the weather, including high heat and or humidity and all other such risks being known and appreciated by me.


I hereby acknowledge my responsibility in communicating any physical and psychological concerns that might conflict with participation in activity. I acknowledge that I am physically fit and mentally capable of performing the physical activity I choose to participate in. It is understood that before participating in any fitness activity, my doctor must first be consulted for personal risks/benefits.


After having read this waiver and knowing these facts, and in consideration of acceptance of my participation and Copperhead Jiu Jitsu services to me, I agree, for myself and anyone entitled to act on my behalf, to HOLD HARMLESS, WAIVE AND RELEASE Copperhead Jiu Jitsu, its officers, seminar instructors, volunteers, agents, employees, landlords, organizers, representatives, and successors from any responsibility, liabilities, demands, or claims of any kind arising out of my participation in the Copperhead Jiu Jitsu training, programs, seminars, and or events.


I do hereby give Copperhead Jiu Jitsu, its assigns, licensees, and legal representatives the irrevocable right to use my name, video, picture, portrait, or photograph in all forms and media and in all manners, including composite, for advertising, for publication or any other lawful purposes, and I waive any right to inspect or approve the finished product, including written copy, which may be created in connection therewith.


By my signature, I indicate that I have read and understand this Waiver of Liability and Photo Release. I am aware that this is a waiver and a release of liability, and I voluntarily agree to its terms.

Done Clear Sign Below:

Medical Conditions

How did you hear about us?

Account Password

Please pick a password to log-in to your account later.

  • Phone

    5412401991

  • Email

    copperheadjiujitsu@gmail.com


  • © Copperhead Pendleton
  • Powered by Gymdesk