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I, {name}, agree that the information provided is accurate to the best of my ability and understand that strict observation by me, of the rules and regulations of Divinus Lux, LLC including the use of protective equipment, will largely eliminate the possibility of accident or injury, and I hereby represent that I am physically and emotionally fit to take martial arts, sport combative martial arts, self-defense training, Brazilian Jiu Jitsu, Judo, or any other offering at Divinus Lux at my own risk with knowledge of risks involved. I further understand and agree that I release from liability and waive any and all claims or actions for personal injury or death or property damage or loss against Divinus Lux, LLC, its owners, officers, operators, employees, volunteers, coaches and affiliated persons, whether caused by the fault, negligence, omission, or any other act however caused, of Divinus Lux, LLC.

PHOTOGRAPHY CONSENT FOR MINORS I hereby grant permission to Divinus Lux Jiu Jitsu, its employees or representatives, to take and use: photographs, videotape and/or digital images of my child for use in promotional or educational materials as follows: printed publications or materials, electronic publications or presentations, websites, social media. I authorize the use of these images indefinitely without compensation to me. All negatives, positives, prints, digital reproductions and videotape shall be the property of the photographer and Divinus Lux Jiu Jitsu. I agree that my child’s name and identity (one must be checked):