Waiver and Health Questionnaire Statement of Risk Martial arts and combat sports training can be dangerous activities. Before beginning any training program with Wrestling for Jiu Jitsu, you should first consult a medical professional. Bruises, scratches, cuts and general soreness are commonplace, and most participants will encounter minor injuries of this nature from time to time in their training. More serious injuries can happen, including sprains and strains and students can expect to encounter these injuries infrequently. The possibility of more serious injury exists, including fractured bones, broken bones, and torn ligaments, although not all students encounter such serious injuries. As with any physical activity, there also exists the remote possibility of death. Name * First Name Last Name Date * MM DD YYYY Please Tick * By ticking the box below you are confirming that you understand the above statement of risk, and accept the responsibility for any training techniques, advice, and/or methodologies mentioned herein. You assume responsibility for your own safety, understanding and accepting all risks involved with martial arts training. By assuming this risk, you completely absolve all authors, creators, and affiliates of Wrestling for Jiu Jitsu from liability for any injury, death or misuse of the information contained herein. You also confirm you have read, understand, and agree to the terms and conditions of this service. I Accept Health Questionnaire Do you know of any reason or medical condition that could affect, or be affected by physical activity? * Yes No Do you have any medical condition that could be made worse by physical activity? * Yes No Do you have a bone or joint disorder that could be worsened by a change in your physical activity? * Yes No Is your doctor currently prescribing any medication which may be affected by you training? * Yes No Do you know of any reason why you should not engage in physical activity * Yes No If you have answered "yes" to any of the questions above, pease provide further details so that we can ensure your safety and wellbeing. By ticking the box below you are confirming that you have read, understood and accurately completed this questionnaire to the best of your knowledge. * I accept Thank you!
