Skip to content
Step
1
of
4
25%
Are you a Student or are you visiting
Student
Visiting from another school
Customer Name
(Required)
First
Last
Email
Phone
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Minors Attending
Minor First Name
Minor Last Name
Add
Remove
Liability Waiver, Terms, and Conditions
(Required)
I agree to the liability waiver below
THIS AGREEMENT MUST BE SIGNED PRIOR TO PARTICIPATING IN ANY Rising Phoenix BJJ TRAINING, CLASS, EVENT, COMPETITION, OR OTHER ACTIVITY (the “Activities”).
PLEASE READ THIS FORM CAREFULLY. Be aware that by signing this WAIVER, RELEASE OF LIABILITY, AND ASSUMPTION OF RISK (the “RELEASE”), you, ON BEHALF OF YOURSELF AND YOUR MINOR CHILD OR WARD, IF APPLICABLE, will be expressly waiving and releasing all claims that you may have against Rising Phoenix BJJ.
In consideration of being allowed to participate in any way in the Activities of Rising Phoenix BJJ, I, the undersigned:
1. Certify that I am in good physical condition, and have no disease, injury or other condition that would impair my performance or physical and mental well-being during the Activities. I have informed or will inform Rising Phoenix BJJ of any conditions I have that may affect my ability to participate in the Activities and understand and agree that, in permitting me to participate in the Activities, Rising Phoenix BJJ has relied on my representation that I am in good health. I understand that failure to disclose all medical conditions, ailments, and other issues further waives Rising Phoenix BJJ’s liability from any and all injuries or other outcomes related to my involvement in the Activities. If at any time I believe that I am unable to participate in the Activities due to physical or medical conditions, I will immediately discontinue participation and will notify Rising Phoenix BJJ of such condition. If emergency medical treatment of me appears to be necessary during any Activity, I consent to such treatment by any local responders or caregivers, if available.
2. Recognize and understand that Brazilian Jiu-Jitsu training is an activity that is inherently dangerous and involves physical contact and that my participation might result in severe bodily injury, including, but not limited to, partial and/or total disability, paralysis and death. Further, I recognize that the social and economic losses and/or damages which could result from these risks and dangers described above, could be severe.
3. Recognize and understand that such risk may be due to not only my own actions, but also the action, inaction or negligence of others, the regulations of participation, or the conditions of the premises, or of any of the equipment used.
4. Recognize that there may be other risks that are not known to me or to others or not reasonably foreseeable at this time.
5. Recognize that some of the Activities require close bodily contact that is not designed or intended to have a sexual nature, intent or context.
6. Understand and agree that I use the equipment and the facilities “As Is” and at my own risk. I agree to inspect the facilities and equipment prior to participation. I will immediately inform an instructor if I believe that anything is unsafe or beyond my capability 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 unsafe area and refuse to participate further.
7. Recognize and understand that in any activity involving a publicly accessible place and involving other people, there is a risk of exposure to bacteria, viruses, or other communicable diseases (including, without limitation, risks associated with COVID-19), toxins, parasites, or other adverse health factors. I agree to exercise reasonable care to minimize exposing others and assume the risk of exposure from others.
8. ASSUME ALL OF THE FOREGOING RISKS AND ACCEPT PERSONAL RESPONSIBILITY FOR ANY DAMAGES THAT MAY RESULT FROM INJURY, PERMANENT DISABILITY OR DEATH.
9. Participate in the Activities entirely of my own free will.
10. RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE Rising Phoenix BJJ, ITS AFFILIATED ORGANIZATIONS AND GOVERNING BODIES, THEIR OFFICERS, INSTRUCTORS AND PERSONNEL, OTHER MEMBERS OF THE ORGANIZATIONS, PARTICIPANTS, SUPERVISORS, COACHES, SPONSORING ORGANIZATIONS OR THEIR AGENTS, AND IF APPLICABLE, OWNERS AND LESSORS OF THE PREMISES (HEREINAFTER REFERRED TO AS “RELEASEES”) FROM ANY AND ALL LIABILITY TO THE UNDERSIGNED, HIS OR HER HEIRS AND NEXT OF KIN FOR ANY AND ALL CLAIMS, DEMANDS, LOSSES AND DAMAGES WHICH MAY BE SUSTAINED AND SUFFERED ON ACCOUNT OF INJURY, INCLUDING DEATH OR DAMAGE TO PROPERTY, CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
11. INDEMNIFY AND HOLD HARMLESS RELEASEES FROM ANY AND ALL LIABILITIES AND EXPENSES (INCLUDING REASONABLE ATTORNEYS’ FEES) OR CLAIMS MADE BY THIRD PARTIES DUE TO MY ACTIONS OR INACTIONS DURING ANY ACTIVITIES. FURTHER, IF THE MINOR ON BEHALF OF WHOM I EXECUTE THIS RELEASE OR ANY OF MY FAMILY MEMBERS, RELATIVES, OR OTHER GUESTS MAKES A CLAIM AGAINST THE RELEASEES, THE UNDERSIGNED WILL INDEMNIFY AND HOLD HARMLESS THE RELEASEES FROM ANY AND ALL LIABILITIES AND EXPENSES (INCLUDING REASONABLE ATTORNEYS’ FEES) RELATED TO SUCH CLAIM. SHOULD THE RELEASEES INCUR ATTORNEYS’ FEES AND COSTS TO ENFORCE THIS RELEASE, I SHALL REIMBURSE TO TOTAL IMPACT ALL SUCH FEES AND COSTS.
12. Certify that I am at least 18 years of age. If under 18, my parent/guardian is the undersigned.
I HAVE READ THE ABOVE WAIVER, RELEASE OF LIABILITY, AND ASSUMPTION OF RISK. I FULLY UNDERSTAND ITS CONTENTS, AND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT. I HEREBY SIGN IT VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, WARRANTY, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY.
Choose Seminar Package – Current Student
One Day
Two Day
How many students attending?
Choose Seminar Package – Visitor
One Day
Two Day
How many visitors attending?
Payment policy
This transaction is subject to a 4% service fee, which reflects the cost of processing credit card payments. The service fee will not apply to payments made with cash or debit cards. By proceeding with this payment, you acknowledge and accept this fee
Total
Credit Card
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number
Expiration Date
Month
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
Year
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
Security Code
Cardholder Name
Signature
Go to Top