Primus Grappling, LLC
South Central PA Judo Foundation
Fitness Services Waiver of Liability & Assumption of Risk
I, _________ {Client Name} , hereby agree by signing this document that I waive certain legal rights, including the right to sue Primus Grappling, LLC and South Central PA Judo Foundation, its owners, trainers, representatives, and facilities for any physical, material, tangible, or intangible loss or damages that may occur during participation in any Fitness Services.
Fitness Services Include (but are not limited to):
Brazilian Jiu-Jitsu, Wrestling, Grappling, Striking/Boxing/Muay Thai, Weight Training & Fitness, Yoga, Toddler & Youth Fitness.
Client Information
Name:{name}
Address: {address}
Phone: {phone}
Date of Birth: {dob}
Fitness Provider Contact
220 S 2nd Street, Dillsburg, PA 17019
Phone: (717) 525-2004
Assumption of Risk
I understand participation in the Fitness Services involves physical contact and inherent risks, including but not limited to muscle strain, sprains, dislocations, transmissible diseases (including COVID-19), broken bones, or worse. I voluntarily choose to participate, and assume all associated risks.
Waiver of Liability
I release Primus Grappling, LLC and South Central PA Judo Foundation, including owners, instructors, volunteers, and staff, from all liability for injuries or losses sustained through participation, even if resulting from negligence or omissions.
Covenant Not to Sue
I will not initiate or join any lawsuit against the Fitness Provider for injury or loss connected to participation in these services.
Indemnification
I agree to defend and indemnify the Fitness Provider against any and all legal claims resulting from my participation or conduct, including reasonable attorney fees.
Medical Disclaimer
I affirm I am medically and physically able to participate. If I require medical attention, I accept full responsibility for related expenses and hold the Fitness Provider blameless.
Uniform & Hygiene Policy
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All members must wear appropriate, clean attire.
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Required: One team gi per member.
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Recommended: Team gi & rash guard for gi classes.
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No-Gi Recommended: Long-sleeve rash guard, spats, and fight shorts.
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Personal hygiene is mandatory: Trimmed fingernails, showered, and fresh clothing.
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All changing must take place in designated locker rooms.
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Locker room use is limited to members age 16 and older. Children under 16 must arrive dressed and may not use the locker rooms unless supervised by a parent/guardian and cleared by staff.
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Profane language is prohibited on the mats or inside the facility.
Kickboxing / Muay Thai Equipment Requirements
For the safety of all students, the following gear is required for participation in striking-based classes (Kickboxing, Muay Thai, or sparring sessions):
Required:
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Hand wraps
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Boxing gloves (12–16 oz depending on size and experience)
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Shin guards (Muay Thai style or full coverage)
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Mouth guard (for all drills/sparring)
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Headgear (for sparring or live contact rounds)
Recommended:
All equipment must be clean and in safe, usable condition. No bare torsos are permitted during training. Sharing personal gear is discouraged unless provided by staff. Students lacking proper safety equipment may not be allowed to participate in live drills or sparring for safety reasons.
Parent/Spectator Policy
Parents and guests may observe quietly from the designated areas. Coaching from the sidelines, interrupting class, or stepping on the mat is strictly prohibited for the safety and focus of all students. Please refer to our Spectator Form for more detail.
Photo/Media Release
I grant Primus Grappling, LLC and South Central PA Judo Foundation permission to use photos or video of myself (or my child) taken during classes or events for promotional, educational, or social media purposes.
Check here if you do NOT give permission to use photos or video of your child.
If this box is checked, Primus Grappling will make every effort to exclude your child from media shared by the school. Please notify staff if you have further questions or concerns.
Governing Law
This waiver shall be governed by the laws of the Commonwealth of Pennsylvania.
I have read, understand, and agree to all terms above. I acknowledge this waiver is legally binding.
Client Name (Printed): ___________________________________
Parent/Guardian Name (if under 18): ________________________
Primus Grappling
