Ozone Brazilian Jiu Jitsu

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You must be 18 years of age or older to complete the following requested information. Please read carefully and fill out to completion.

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The account holder responsible for payments

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Student Names

Students use the + sign to add multiple (if other than self)

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Medical History

Please list any current or pre-existing injuries or medical conditions including date of onset and student name if more than one student:

Medical History

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WAIVER AND RELEASE OF LIABILITY(Required)

BY CHECKING THIS BOX I AFFIRM THAT I AM OF THE AGE OF 18 YEARS OR OLDER, AND THAT I AM FREELY SIGNING THIS AGREEMENT. I CERTIFY THAT I HAVE READ THIS AGREEMENT, THAT I FULLY UNDERSTAND ITS CONTENT AND THAT THIS RELEASE CANNOT BE MODIFIED ORALLY. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND THAT I AM SIGNING IT OF MY OWN FREE WIL IN THE EVENT THAT THE PARTICIPANT IS UNDER THE AGE OF CONSENT (18 YEARS OF AGE), THEN THIS RELEASE MUST BE SIGNED BY A PARENT OR GUARDIAN, AS FOLLOWS: I HEREBY CERTIFY that I am the parent or legal guardian of minor, named below, and do hereby give my consent without reservation to the foregoing on behalf of this individual.

ALL guests/participants/students or children that plan to be on the mats or play within the Ozone Brazilian Jiu Jitsu facility, must have a signed Waiver and Release of Liability form, regardless of participation in any of the classes, programs, or events. Exceptions will be made for spectating guests ONLY.

Children that are not students: All children brought into the Ozone Brazilian Jiu Jitsu Facility must have a parent signed Release of Liability Waiver on file regardless of their non-member status and are expected to be closely monitored by a parent or legal guardian at all times. No exceptions will be made.

Participation. In consideration of being permitted to participate in any way in the Ozone Brazilian Jiu Jitsu programs and/or being permitted to enter for any purpose any restricted area (herein defined as any area where admittance to the general public is prohibited), I (or parent/guardian of) the participant named below, agree to the following:

Prior to participating in any physical activities or events, I should and will inspect the facilities and equipment to be used, and if I believe anything is unsafe, I should and will immediately inform the instructor or officials of such conditions and refuse to participate. I understand and agree that, if at any time, I feel anything to be unsafe, I will immediately take all precautions to avoid the area of concern and refuse to participate any further.

IN CONSIDERATION OF the risk of injury that exists while participating in MIXED MARTIAL ARTS, INCLUDING BUT NOT LIMITED TO BRAZILIAN JIU JITSU (hereinafter the “Activity”); and IN CONSIDERATION OF my desire to participate in said Activity and being given the right to participate in the same; I HEREBY, for myself, my heirs, executors, administrators, assigns, or personal representatives (herein referred to as “Releasor,” “I,” or “me,” which terms shall also include Releasor’s parents or guardian if Releasor is under 18 years of age), knowingly and voluntarily enter into this WAIVER AND RELEASE OF LIABILITY and hereby waive any and all rights, claims, or causes of action of any kind arising out of my participation in the Activity; and I HEREBY release and forever discharge OZONE BRAZILIAN JIU JITSU, located at [Address], any other franchise, franchisee, their affiliates, directors, officers, managers, instructors, independent contractors, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors, and assigns (collectively “Releasees”), from any physical or psychological injury that I may suffer as a direct result of my participation in the aforementioned Activity.

I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO: PROPERTY DAMAGE, PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, DISFIGUREMENT, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS’ NEGLIGENCE, CONDITIONS RELATED TO TRAVEL TO AND FROM THE ACTIVITY, OR FROM CONDITIONS AT THE ACTIVITY LOCATION(S). NONETHELESS, I ASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY.

I, THE UNDERSIGNED, also expressly acknowledge the injuries received may be compounded or increased by negligent rescue operations or procedures of the Releasees.

I, THE UNDERSIGNED, further expressly agree that the foregoing release, waiver, and indemnity agreement are intended to be as broad and inclusive as permitted by the laws of the State of California or State in which the Releasees may participate in activities or events, and if any portion is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal effect.

I FURTHER AGREE to indemnify, defend, and hold harmless the Releasees against any and all claims, suits, or actions of any kind whatsoever for liability, damages, compensation, or otherwise brought by me or anyone on my behalf, including attorney’s fees and any related costs.

I HEREBY RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE the Releasees, and any promoters, lessees, lessors of premises used to conduct any activity related to a mixed martial arts program or event, premises and event inspectors, underwriters, consultants, and others who may provide recommendations, directions, or instructions to engage in risk evaluation or loss control activities regarding the Ozone Brazilian Jiu Jitsu facility or events held at such facility, FROM ALL LIABILITY TO THE UNDERSIGNED, FOR ANY AND ALL CLAIMS, DEMANDS, LOSSES, OR DAMAGES AND ANY CLAIMS OR DEMANDS, THEREFORE ON ACCOUNT IF ANY INJURY, INCLUDING, BUT NOT LIMITED TO THE DEATH OF MYSELF OR DAMAGE TO PROPERTY, ARISING OUT OF OR RELATING TO THE EVENT(S) CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

I FURTHER ACKNOWLEDGE that Releasees are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Releasees. In the event that I should require medical care or treatment, I authorize Ozone Brazilian Jiu Jitsu to provide all emergency medical care deemed necessary, including but not limited to, first aid, CPR, the use of AEDs, emergency medical transport, and sharing of medical information with medical personnel. I further agree to assume all costs involved and agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I am to carry my own health insurance.

I FURTHER ACKNOWLEDGE that this Activity may involve a test of a person’s physical and mental limits and may carry with it the potential for death, serious injury, and property loss. I agree not to participate in the Activity unless I am medically able and properly trained, and I agree to abide by the decision(s) of the Ozone Brazilian Jiu Jitsu officials or agents regarding my approval to participate in the Activity.

I FURTHER ACKNOWLEDGE that I am executing a legal document of importance stating my inability to sue or make any claim against the Releasees and anyone hosting or conducting a seminar, demonstration, competition, or anyone renting, providing facilities, or equipment to the Releasees. Signing this Waiver and Release of Liability (“form” or “release”) is a requirement for anyone who will not be sitting or standing as a spectator, and the Form must be signed prior to participating in any activity offered by the Releasees. The Releasees will not offer me any training or instruction without signing this Form.

I FURTHER ACKNOWLEDGE that by signing this Form, I am expressing to the Releasees, my understanding that in the instance in which I acquire an injury of any sort or severity, the Releasees are not to provide insurance, medical reimbursement, and will not be liable for the undersigned in any way

.

I HEREBY ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS “WAIVER AND RELEASE” AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE Ozone Brazilian Jiu Jitsu, and all Franchises, Franchisees AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS, AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST Ozone Brazilian Jiu Jitsu FOR PERSONAL INJURY OR PROPERTY DAMAGE.

To the extent that statute or case law does not prohibit releases for ordinary negligence, this release is also for such negligence on the part of the Releasees.

I agree that this Release shall be governed for all purposes by California law, without regard to any conflict of law principles. This Release supersedes any and all previous oral or written promises or other agreements.

In the event that any damage to equipment or facilities occurs as a result of my or my family’s or my agent’s willful actions, neglect, or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any such actions of neglect or recklessness.

THIS WAIVER AND RELEASE OF LIABILITY SHALL REMAIN IN EFFECT FOR THE DURATION OF MY PARTICIPATION IN THE ACTIVITY, DURING THIS INITIAL AND ALL SUBSEQUENT EVENTS OF PARTICIPATION.

THIS AGREEMENT was entered into at arm’s length, without duress or coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both Participant, and Ozone Brazilian Jiu Jitsu agree that this agreement is clear and unambiguous as to its terms, and that no other evidence shall be used or admitted to alter or explain the terms of this agreement, but that it will be interpreted based on the language in accordance with the purposes for which it is entered into.

In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase, or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect. If a court should find that any provision of this agreement is invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed, and enforced as so limited.

By CHECKING THIS BOX our membership contract, you acknowledge that you have read, understood, and agreed to this Privacy Policy and consent to the collection, use, and sharing of your personal information as described herein. If you do not agree with this Privacy Policy, please do not proceed with your membership application or contact us to discuss any concerns or questions.

**Section 1: Information We Collect**

We collect various types of information from our members to provide you with the best martial arts experience possible. The types of information we may collect include:
1. Personal Information: This may include your name, contact information (such as email address, phone number, and mailing address), date of birth, emergency contact information, and other details required for membership registration.
2. Health Information: To ensure your safety while participating in martial arts training, we may collect information about your health and any medical conditions or injuries that may affect your participation.
3. Billing Information: We collect payment and billing information, such as credit card details, to process membership dues and other related fees.
4. Training and Attendance Information: We keep records of your training sessions, attendance, and performance to track your progress and provide tailored martial arts instruction.
5. Photographs and Videos: We may take and use photographs and videos during martial arts classes or events for promotional and instructional purposes with your consent.

**Section 2: How We Use Your Information**

We use the information we collect for the following purposes:
1. Membership Management: We use your personal information to manage your membership, process payments, and communicate with you about our services and any updates or changes to your membership.
2. Safety and Instruction: Your health and training information help us provide a safe and effective training environment. We may use this information to tailor our instruction to your needs and ensure your well-being.
3. Promotional Activities: With your consent, we may use photographs and videos featuring your likeness for promotional activities, such as social media posts, website content, or marketing materials.
4. Legal Compliance: We may use your information to comply with applicable laws and regulations.

**Section 3: Information Sharing and Disclosure**

We do not sell or rent your personal information to third parties. However, we may share your information in the following circumstances:
1. Service Providers: We may share your information with third-party service providers who help us manage and operate our martial arts academy, process payments, and provide other essential services.
2. Legal Requirements: We may disclose your information when required by law, such as in response to a court order, subpoena, or other legal process.
3. Safety and Security: We may share your information to protect the safety and security of our members, staff, or others, or to investigate and prevent fraudulent or illegal activities.

**Section 4: Your Choices and Rights**

You have certain rights concerning your personal information, including the right to access, correct, or delete your information. You can also withdraw consent for promotional activities involving your likeness. To exercise these rights or for any questions or concerns regarding your personal information, please contact us at our direct line: (951) 501-6209.

**Section 5: Security**

We take reasonable measures to safeguard your personal information from unauthorized access, disclosure, or alteration. However, no method of transmission over the internet or electronic storage is completely secure, so we cannot guarantee absolute security.

**Section 6: Updates to this Privacy Policy**

We may update this Privacy Policy from time to time to reflect changes in our practices or for legal or regulatory reasons. We will notify you of any significant changes by posting an updated Privacy Policy online or by other appropriate means.

By signing our membership contract, you acknowledge that you have read, understood, and agreed to this Privacy Policy and consent to the collection, use, and sharing of your personal information as described herein.

If you do not agree with this Privacy Policy, please do not proceed with your membership application or contact us to discuss any concerns or questions.

Payment Authorization Information and Agreement

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