Hiscoe Jiu-Jitsu Limited

ACKNOWLEDGEMENT AND RELEASE FORM

I, ___________________________________, on behalf of myself, members of my family, my heirs, executors, administrators and assigns, hereby forever release, discharge and hold harmless, Hiscoe Jiu-Jitsu Limited, representatives and agents for any injury, loss or damage to my person or property howsoever caused, arising out of or in connection with me taking part in Martial Art Classes, Self Defense Seminars and activities and notwithstanding that the same may have been contributed to or occasioned by the negligence of Hiscoe Jiu-Jitsu Limited, representatives or agents.  
Please note:  Participants must supply their own protective equipment. The waiver was read and he/she agrees to abide by it.

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Student Name                                                                      Parent or Guardian (if under 18)

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Student Signature                                                               Parent or Guardian Signature