I, {name}, of my own will and accord hereby release Renzo Gracie Academy Des Moines, the instructors sponsoring the classes, and their respective employees, agents, heirs and assigns from any and all claims from injury or damage that may be sustained by me while participating in the Renzo Gracie Academy Des Moines classes. Participating in Jiu Jitsu is similar to other sporting activities in that they contain certain risks inherent in every sport. Specifically, I fully understand that Renzo Gracie Academy Des Moines classes involve physical contact which could lead to physical injury. In addition, I fully understand that the Renzo Gracie Academy Des Moines classes involve physical exercise and body conditioning which may result in experience of pain on my part.
I hereby irrevocably agree and consent that Renzo Gracie Academy Des Moines, the instructors sponsoring the classes, and their respective employees, agents, successors and assigns, may use all or part of any videotapes, films or photographs of me made by them for any of their promotional materials (including, without limitation, flyers, brochures, posters, websites, and promotional videos for broadcast and non-broadcast use). They may use my picture, silhouette and other reproductions of my likeness in connection with any such promotional materials. They may edit my appearance as they see fit. They shall have all right, title and interest in any and all results and proceeds from said use or appearance.
Further, I hereby represent that I am in good health and capable of participating in such a program and that I will do nothing which will cause injury to myself or others while engaging in the Renzo Gracie Academy Des Moines classes. Further, I will hold Renzo Gracie Academy Des Moines, the instructors sponsoring the classes, and their respective employees, agents, heirs and assigns harmless in connection with my participation.
I have read, understand and agree to abide by the above waiver of liability.
Renzo Gracie Academy Des Moines
