Tertiary Email Address

Membership Registration

Registration Instructions:

1) Choose the program and membership

2) Select the first class (take pic or write it down)

3) Enter contact info (include first and last name)

Kids BJJ

Kids 12-month Contract (Unlimited)

$179.95 / Month

This is the best After-school Program for kids. Here at 99 Jiu Jitsu HQ, kids will not only have lots of fun, but will also be pushed to their limits. Safe and clean environment will assure your child's safety.

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Kids 12-month Contract (Up to 12 classes per month)

$164.95 / Month

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Kids 12-month Contract (Up to 8 classes per month)

$149.95 / Month

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Kids 6-month Unlimited

$199.95 / Month

$50.00 Registration Fee

If Cancelled before Expiration date, a $250 Cancellation fee will be applied to your credit/debit card.

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Adults BJJ

Adults 12-month BJJ (Unlimited)

$189.95 / Month

$50.00 Registration Fee

Membership will be renewed automatically, unless you contact us to pause, or cancel. You're allowed to pause your membership for a maximum of 2 months. If cancelled before expiration date, a $300 cancellation fee will be applied to your credit/debit card.

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Adult 12-month BJJ (3x per week)

$174.95 / Month

$50.00 Registration Fee

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Adult 12-month Contract (2x per week)

$159.95 / Month

12-month commitment plan. Great for locals willing to get the most out of it. Attend up to 8 classes (of your choice).

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10 Class Pack

$250.00

Great plan for those who are just starting jiu jitsu, for those who travel a lot, or those whose schedules are very flexible.

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Month-to-Month Unlimited (NO CONTRACT)

$249.95 / Month

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Adult 6-Month Contract (Unlimited)

$209.95 / Month

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Adults 6-Month Contract (2x per week)

$179.95 / Month

$50.00 Registration Fee

If Cancelled before Expiration date, a $250 Cancellation fee will be applied to your credit/debit card.

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Beginners Program 3x (20%off)

$133.00 every 2 week(s)

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Striking

INFO

Name

Parent's Name (if youth is under age 18)

Phone Number Sms Opt-In

By opting in to SMS, the Person agrees to receive announcements and billing alerts from 99 Jiu Jitsu HQ.

Standard messaging rates may apply. Messaging cadence may vary. Reply STOP to opt out.

Address

Birthdate

Sex

SHOPPING CART

Subtotal

$0.00

AGREEMENT

99 Jiu Jitsu HQ Liability Waiver Form

To the best of my knowledge, I am in good physical condition and fully able to participate in this course. I am fully aware of the risks and hazards connected with the participation in Brazilian Jiu-Jitsu, Judo, Muay Thai Kickboxing, Karate, Hapkido, Bootcamp Training, Weightlifting, or Aerobics, including physical injury or even death, and herby elect to voluntarily participate in said event, knowing that the associated physical activity may be hazardous to me and my property. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OR LOSS, PROPERTY DAMAGE, OR PERSONAL INJURY, INCLUDING DEATH, that may be sustained by me, or loss or damage to property owned by me, as a result of participation in this course. I further certify that I am at least 18 years of age. If under 18, my parent/guardian is the below signed.

I hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE, 99 Jiu Jitsu HQ, Eduardo Telles Moreira, their officers, servants, agents, and employees (hereinafter referred to as RELEASEES) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, while participating in physical activity, or while on or upon the premises where the event is being conducted.

It is my expressed intent that this release and hold harmless agreement shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a RELEASE, WAIVE, DISCHARGE, and CONVENTION TO SUE the above named RELEASEES. I hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be constructed in accordance with the laws of the State of California.

In signing this release, I acknowledge and represent that I HAVE READ THE FOREGOING Waiver of Liability and Hold Harmless Agreement, UNDERSTAND IT AND SIGN IT VOLUNTARILY as my own free act and deed; no oral representations, statements or inducements, apart from the foregoing written agreements have been made; and I EXECUTE THIS RELEASE FOR FULL, ADEQUATE AND COMPLETE CONSIDERATION FULLY INTENDING TO BE BOUND BY SAME.

Student’s Printed Name:

Date of Birth:

Signature of responsible:

SIGN HERE

Membership Registration

INFO

SHOPPING CART

Subtotal

$0.00

AGREEMENT

SUMMARY

Total

$0.00

BILLING INFO