ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
I, THE UNDERSIGNED, HEREBY EXECUTE THIS ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM (“Form”), and agree and/or affirm the following: 1. I hereby release, hold harmless, and promise not to sue Bullseye Axe Lounge or its shareholders, directors, officers, employees, managers, representatives, agents, property owners, or landlords (collectively “Lounge”) for any claim, damage, liability, or obligation, whether known or unknown, contingent or not contingent, or direct or indirect, arising from the negligence (gross or otherwise), actions, or omissions of Lounge; the negligence (gross or otherwise), actions, or omissions of other patrons, invitees, participants, or other guests of Lounge (“Patrons”); dangerous or defective equipment or property owned, maintained, used, or controlled by Lounge; my own actions in participating in Lounge’s activities, entertainment, events, or any and all other offered services (collectively “Lounge Entertainment”); or from any and all other possible liability-without-fault claims that may arise from my participation in Lounge Entertainment. 2. I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN LOUNGE ENTERTAINMENT; AFFIRM MY UNDERSTANDING OF THE POSSIBILITY OF INJURY, SERIOUS INJURY, DISABILITY, DEATH, OR PROPERTY DAMAGE THAT MAY RESULT DUE TO MY PARTICIPATION IN LOUNGE ENTERTAINMENT, FROM PATRONS, OR FROM LOUNGE’S FACILITIES OR EQUIPMENT; WAIVE ANY CLAIMS AGAINST, RELEASE, AND FOREVER DISCHARGE LOUNGE FOR ANY LIABILITY THAT MAY ARISE DUE TO MY INJURY, SERIOUS INJURY, DISABILITY, DEATH, OR PROPERTY DAMAGE THAT RESULTS FROM MY PARTICIPATION IN LOUNGE ENTERTAINMENT FROM PATRONS, OR FROM LOUNGE’S FACILITIES OR EQUIPMENT. 3. I certify that there are no health-related reasons or problems that preclude my participation in Lounge Entertainment. 4. I acknowledge that this Form will be used by Lounge, and that it will govern my actions and responsibilities at Lounge’s Premises. 5. In consideration of my application and permitting me to participate in Lounge Entertainment, this Form shall be binding upon myself, my executors, administrators, heirs, next of kin, successors, and assigns. 6. I hereby indemnify and hold harmless Lounge from any and all liabilities, obligations, or claims arising from my participation in Lounge Entertainment. 7. I hereby consent to receive medical treatment that may be deemed advisable in the event of injury, accident, and/or illness during this activity. 8. I understand that while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by Lounge. 9. This Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. 10. I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL. _______________________________________________ ____________________ ____________________________________________________ Participant Name Date Participant’s Signature COMPLETE SECTION BELOW IF PARTICIPANT ABOVE IS A MINOR: I am the parent or legal guardian of the minor named above. I have the legal right to consent to and, by signing below, I hereby do consent to the terms and conditions of this Accident Waiver and Release of Liability Form.
RAGING BULL RAGE ROOM WAIVER TO:
Raging Bull/Bullseye and their respective directors, officers, employees, guides, agents, representatives, volunteers, independent contractors, subcontractors, sponsors, successors and assigns (all of whom are hereinafter collectively referred to as the “Releases”). DEFINITION In this Release Agreement, the term “Sports” shall include any use or participation in the Rage Room facility and related equipment, and any other activities, events or services provided, arranged, organized, sponsored or authorized by the Releases in any way associated or connected with the Rage Room. ASSUMPTION OF RISKS I am aware that the Sports involves unusual risks, dangers and hazards including, but not limited to: accidents which may occur in the facility; slips and falls; malfunction of the equipment used; injury and open wounds; shock, stress or other injury to the body while participating in the Sports; negligence on the part of other persons; and NEGLIGENCE ON THE PART OF THE RELEASES. I UNDERSTAND THAT NEGLIGENCE INCLUDES FAILURE ON THE PART OF THE RELEASEES TO TAKE REASONABLE STEPS TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF THE SPORTS. I acknowledge that the Sports may result in injury, worsening of an existing medical condition, or death. I freely accept and fully assume all such risks, dangers and hazards and the possibility of injury, death, property damage or loss resulting therefrom. MEDICAL CONDITION I understand that the Sports may place unusual stresses on the body. The Sports are not recommended for persons suffering from asthma, epilepsy, cardio/respiratory disorder, hypertension, or skeletal, joint or ligament problems or conditions, and certain mental illnesses. Women who are pregnant or suspect they are pregnant, and persons who have consumed alcohol, are not recommended to engage in the Sports. I have been advised to consult with my medical practitioner if I have any concern about my medical condition or fitness to engage in the Sports. RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT In consideration of the Releases agreeing to my participation in the Sports, and permitting my use of the Sports’ equipment, room and other facilities, I hereby agree as follows: 1. TO WAIVE ANY AND ALL CLAIMS AND TO RELEASE THE RELEASES from any and all liability for any loss, damage, expense or injury including death that I may suffer, or that my next of kin may suffer, as a result of my participation in the rage room, DUE TO ANY CAUSE WHATSOEVER, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE, INCLUDING ANY DUTY OF CARE ON THE PART OF THE RELEASES. I UNDERSTAND THAT NEGLIGENCE INCLUDES THE FAILURE ON PART OF THE RELEASES TO TAKE REASONABLE STEPS TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF THE SPORTS; 2. TO HOLD HARMLESS AND INDEMNIFY THE RELEASES from any and all liability for any property damage or personal injury to any third party resulting from my participation in the Sports; 3. This Release Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns and representatives, in the event of my death or incapacity; 4. This Release Agreement and any rights, duties and obligations as between the parties to this Release Agreement shall be governed by and interpreted solely in accordance with the laws of the state of Illinois and no other jurisdiction; 5. Any litigation involving the parties to this Release Agreement shall be brought solely within the city of Chicago and shall be within the exclusive jurisdiction of the Courts of Illinois. PHOTO/VIDEO RELEASE - I consent to photographs and videos being taken of me during my participation in the Sports, and to publication of the photographs and videos by the Releases for advertising, promotional and marketing purposes. In entering into this Release Agreement, I am not relying on any oral or written representations or statements made by the Releases with respect to the safety of the Sports, other than what is set forth in this Release Agreement. I CONFIRM THAT I HAVE READ AND UNDERSTOOD THIS RELEASE AGREEMENT PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS RELEASE AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASES.
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