Membership Sign-up Form

In consideration of my being permitted by Forca Training Centre ("Forca") to use the facilities rented and operated by Forca, I agree to the following waiver and release and I make the following representations: 

I hereby acknowledge the inherent risks in Brazilian Jiu Jitsu, Muay Thai Kickboxing, Mixed Martial Arts, Judo, Striking, Grappling, and Resistance Training. I realize that those risks involve, but are not limited to: falls from contact with walls and/or equipment, bad decision making by myself and others, inattention of instructors or action of other participants, misuse of equipment by myself or others, failure of equipment, improper and/or incorrect use and/or application of techniques of submission or other means of self-defense and/or fighting, and unforeseen and unforeseeable accidents. I acknowledge that the above list does not include all possible risks associated with the use of the facilities, and/or the practice of Brazilian Jiu Jitsu, Muay Thai Kickboxing, Mixed Martial Arts, Striking, Grappling, Judo, or Resistance Training and agree that the extent of this release is in no way limited by this list

I voluntarily assume all such physical and legal risks with full knowledge and appreciation of the danger and the risk of personal injury, including paralysis and death, which may occur while I am in the facilities, or participation in any event or program, or while I am practicing Brazilian Jiu Jitsu, Muay Thai Kickboxing, Mixed Martial Arts, Striking, Grappling, Judo, or Resistance Training anywhere at any time, whether or not under supervision of Forca's personnel, I hereby knowingly and intentionally waive and release, and agree to indemnify, hold harmless, and defend Forca, its successors, assigns, officers, employees, representatives, and agents from all liability for any such damage, injury, paralysis, or death which may result. This release shall be effective even though said loss, damage, or injury results or has resulted from the negligence, wrongful acts, omissions, breach of warranty, or strict tortuous liability of Forca and/or the other parties herein released

I understand that this release is a contract. All releases provided herein by myself shall be effective and binding upon my assigns, heirs, representatives, executors, and administrators. I expressly state that I have read, understand, and am familiar with and consent to all of the provisions and that I sign it willingly

I am at least nineteen years of age and otherwise legally competent to sign this agreement

I recognize the extreme physical demands of Forca Training Centre and have been advised by Forca to consult a physician before taking part in this program

Name: {name}                     Date of Birth: {dob}                             Phone Number: {phone}

Address: {address}                        Date: {sign_date}