BBJJ Valentine's Day Parents Night Out Which school will you be visiting?*Cobble Hill (Columbia Street)Clinton Hill (Myrtle Avenue)Bensonhurst (Bay Parkway)Dyker Heights (13th Avenue)Gravesend (Avenue U)Child's Name* First Last Parent's Name* First Last Child's Age* Date of Birth* Your Phone Number* Your Email* What's the best way to reach you?*PhoneTextEmailWho do you know at our school?* Waiver/Liability Release*Activity: Brooklyn Brazilian Jiu-Jitsu & Shotokan Karate Center II Assumption of Risks I acknowledge that, as parent or legal guardian of the participant child, I have voluntarily applied my child to participate, and consent to his/her participation, in a martial arts training activity with full knowledge that he/she is a voluntary participant. I understand this training involves numerous risks including but not limited to: falling, punches, kicks, hitting walls, grappling and other mixed martial arts. I understand emergency treatment may be difficult to reach or slow in arriving. I also understand there are unforeseen and unforeseeable hazards in this type of training and that insurance coverage is not provided for this activity. I understand it is my responsibility to protect myself and my child at all times and practice safe training conduct at all times. I agree that I am fully responsible for my child's welfare. I accept any and all risks of delay, unanticipated events, injury, emotional trauma and death and verify this statement. Release of Liability I acknowledge that there are specific costs and expenses to Shotokan Karate Center and Brooklyn Brazilian Jiu- Jitsu (BBJJ) for conducting this activity and training. I acknowledge that these costs and expenses are lawful consideration in exchange for my being permitted to participate. I HEREBY AGREE NOT TO SUE AND RELEASE AND DISCHARGE SKC, BBJJ AND ALL INSTRUCTORS AND ANY AND ALL TRAINING PARTICIPANTS INVOLVED IN THE TRAINING ACTIVITY FROM AND AGAINST ANY AND ALL LIABILITY ARISING FROM OR IN ANY WAY RELATED TO MY CHILD'S PARTICIPATION. I agree this release shall be legally binding upon me, my heirs, successors, assigns and legal representatives. It is my intention to fully assume all risks of participation as part of this release to the maximum extent permitted by law. I have carefully read and fully understand the contents and legal ramifications of this agreement. I understand this is a legally binding and enforceable contract and sign it of my own free will. Parent/Guardian First Name Parent/Guardian Last Name NameThis field is for validation purposes and should be left unchanged.