GroundControl Intro Membership Special Offer

GROUND CONTROL MARTIAL ARTS – PARTICIPANT WAIVER & RELEASE FORM

Participant Information

• Full Name: {name}

• Date of Birth: {dob}

• Address: {address}

• Phone: {phone}

• Emergency Contact Name: {contact_name}

• Emergency Contact Relationship: {contact_relation}

• Emergency Contact Phone: {contact_phone}

1. Acknowledgment of Risk & Physical Contact I, {first_name}, understand that Brazilian Jiu-Jitsu, striking, and martial arts training involve high-intensity exertion, dynamic movement, and direct physical contact (including joint submissions, chokes, throws, sweeps, and live sparring). I acknowledge that these activities carry inherent risks of physical injury, including but not limited to soft tissue injuries, sprains, fractures, concussions, skin infections, or severe bodily harm. I voluntarily assume all risks associated with my presence, training, and participation at GroundControl Martial Arts. Initials:

2. Health & Medical Fitness Declaration I warrant that I am in good physical health and free from any medical condition, injury, or contagious illness that would render my participation unsafe for myself or others. I agree to notify instructors immediately of any health changes, injuries, or physical discomfort during class, and to cease participation if it becomes unsafe to continue. Initials:

3. ACC Coverage & Liability Release (New Zealand) I acknowledge that personal injury in New Zealand is governed by the Accident Compensation Act 2001 (ACC). To the maximum extent permitted by New Zealand law, I release, waive, and discharge GroundControl Martial Arts, its directors, instructors, staff, and agents from any claims, demands, or liabilities arising from injury, loss, or damage sustained during training, save for entitlements provided under the ACC statutory scheme. Initials:

4. Media & Promotional Release I grant GroundControl Martial Arts permission to capture and use my image, photo, or video footage taken during training, competitions, or academy events for promotional, marketing, website, and social media channels without compensation or prior approval.

5. Guardian Authorization (For Minors Under 18 Years) If the participant listed above ({name}) is under 18 years of age, I confirm that I am their legal parent or guardian. I grant permission for their participation, accept all terms of this waiver on their behalf, and acknowledge the inherent risks involved in combat sports training.

Signature & Verification

• Signee Name:

• Date Signed: {sign_date}