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WAIVER
Clobber Jiu Jitsu Waiver
First Name
Last Name
Email
Date of Birth
Are you physically capable to participate in Brazilian Jiu Jitsu?
No
Yes
Please specify if you have any physical limitations that we should know about.
Initials
I declare that the info I’ve provided is accurate & complete
I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.
Submit
Thanks for submitting!
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