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.
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