Waiver Form Youth

Youth Program Waiver and Membership Cancellation Policy

Please Read Carefully

Acknowledgment of Participation

I, the undersigned parent or legal guardian, hereby give permission for my child to participate in classes, training, and related activities at Tupelo Jiu-Jitsu Academy, located at 811B Varsity Drive, Tupelo, MS 38801.

Assumption of Risks

I understand that Brazilian Jiu-Jitsu is a physical activity involving close contact, movement, and exertion. I recognize that participation may involve the risk of injury, including but not limited to bruises, strains, sprains, fractures, or other physical harm. I accept these risks on behalf of my child and acknowledge that participation is voluntary.

Release of Liability

In consideration of my child being allowed to participate in activities at Tupelo Jiu-Jitsu Academy, I hereby release, discharge, and hold harmless Tupelo Jiu-Jitsu Academy, its owners, instructors, staff, volunteers, and affiliates from any and all claims, demands, actions, or causes of action that may arise out of my child’s participation, except in cases of gross negligence or intentional misconduct.

Medical Disclosure

I certify that my child is in good physical condition and has no known medical condition or injury that would prevent safe participation in Jiu-Jitsu. I agree to inform the academy immediately of any change in my child’s health or medical status.

In the event of an emergency, I authorize Tupelo Jiu-Jitsu Academy staff to seek medical attention for my child if I cannot be reached, and I assume full financial responsibility for any resulting expenses.

Photo and Video Release

I grant Tupelo Jiu-Jitsu Academy permission to use photographs, videos, or likenesses of my child for promotional, educational, or informational purposes, including use on social media, the academy website, or printed materials, without compensation.

Code of Conduct

I agree that my child will show respect to instructors, staff, and fellow students and will follow all academy rules and safety guidelines. I understand that Tupelo Jiu-Jitsu Academy reserves the right to suspend or terminate participation for unsafe, disrespectful, or disruptive behavior.

Membership Cancellation Policy

As a parent or guardian of a student enrolled at Tupelo Jiu-Jitsu Academy, I understand that consistent attendance and commitment are important for my child’s progress and for the smooth operation of the academy. However, if I choose to cancel my child’s membership, I agree to the following terms:

1. Written Notice Requirement
A written notice of cancellation must be submitted to Tupelo Jiu-Jitsu Academy to begin the cancellation process. The notice should include the child’s name, membership details, and the desired effective date of cancellation.

2. 30-Day Notice Period
All cancellations require a 30-day notice period. The membership will remain active for 30 days after the academy receives the written cancellation notice, and any dues during this time remain the responsibility of the member.

3. Delivery Options
Cancellation notices may be delivered in any of the following ways:

• In Person: Submit a written notice at 811B Varsity Drive, Tupelo, MS 38801.

• Mail: Send a signed letter with all details to the address above.

• Email: Send an email to [email protected] using the email address on file.

4. Responsibility During Notice Period
I understand that I am responsible for any dues or fees incurred during the 30-day notice period. No refunds will be issued for dues or fees paid prior to the effective cancellation date unless otherwise stated by the academy’s refund policy.

By signing below, I acknowledge that I have read, understood, and agree to the above cancellation policy.

Governing Law

This agreement shall be governed by and construed in accordance with the laws of the State of Mississippi, and any legal action related to this waiver shall be brought in the courts of Lee County, Mississippi.

Parent/Guardian Consent and Signature

I have carefully read and fully understand this Youth Program Waiver and Membership Cancellation Policy. I voluntarily sign it on behalf of my child with full knowledge of its contents and legal implications.