Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Student Name *FirstLastEmail *Phone *Student's Birth Month *JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberStudent's Birth Date *12345678910111213141516171819202122232425262728293031 if Program Batch Select Program *Walk-inToddler (2.5 - 4.5 yrs old)Student Rate 12-Month Lock-inStudent Rate 6-Month Lock-inStudent Rate 3-Month Lock-inRegular Student Rate MembershipAdult Membership 12-Month Lock-inAdult Membership 6-Month Lock-inAdult Membership 3-Month Lock-inRegular Adult MembershipSiblings Discount 6-Month Lock-inSiblings Discount 3-Month Lock-inFamily of 3 Discount 6-Month Lock-inFamily of 4 Discount 6-Month Lock-inParagraph TextBatch Enrollment Schedule *Every 1stEvery 16thN/A Not Applicable Drop-in onlyParent's / Guardian's Name if Minor OnlyFirstLastTerms and ConditionI, ___ entirely upon my own initiative and risk and responsibility am about to participate in Brazilian Jiu-Jitsu training at Fraction Fitness Studio. I am at least 18 years of age. If I am under 18 years of age, a parent or guardian will sign below on my behalf. I understand that Brazilian Jiu-Jitsu can cause serious injury or even death. I will be learning to immobilize an opponent by choking them unconscious or causing major trauma to joints such as the shoulder, knee, or elbow. At some point everyone who trains in Brazilian Jiu-Jitsu long enough will suffer at least a minor injury. Knowing all of the above, I freely choose to participate in class and acknowledge my risk. Therefore, I do hereby for myself, my heirs, executors, and administrators release and hold harmless to Fraction Jiu Jitsu, and the instructors from any and all liability, negligence, claims demands, actions or causes of actions, or caused of actions resulting from any participation in this sport/activity/class and associated activity. If age under 18, must be accomplished by Parents/Guardian.Submit