Please fill out this waiver
Team Escape 262 and West Bend Axe and Escape
ACCIDENT WAIVER AND RELEASE OF LIABILITY OF:
Team Escape 262
N80 W14942 Appleton Ave.
Menomonee Falls, Wisconsin, 53051
West Bend Axe and Escape
1640 S. Main Street
West Bend, WI 53095
In consideration for being permitted in Team Escape 262 and West Bend Axe and Escape and the related activities (collectively, “activities”) conducted by and at Team Escape 262 and West Bend Axe and Escape. Team Escape 262 and West Bend Axe and Escape RESERVES THE RIGHT TO REFUSE ENTRY TO THE FACILITY IF THE EMPLOYEES OR STAFF BELIEVES THAT PARTICIPANTS COULD CREATE A RISK OF HARM TO THEMSELVES OR OTHER PARTICIPANTS.
Assumption of Risk: I realize that myself or my child/ward’s participation in this live escape game brings with it potential risks. By booking and participating in this event, myself and/or my child agree to assume all risks of participating in any/all activities associated with this event and it is my voluntary and informed decision to release any future lawsuits or claims that they may have against the releasees. Therefore, I agree on behalf of myself and my child/ward and our personal representative, successors, heirs, and assigns to hold Team Escape 262 and West Bend Axe and Escape and its affiliates, officers, directors, agents, employees, designers, licensors, and members, as well as the property owner and tenants of the property and the owners, manufacturers and installers of the equipment comprising the Team Escape 262 and West Bend Axe and Escape facility (collectively, the “Releasees”) harmless from any and all claims or causes of action arising out of me and/or my child/ward’s participation at Team Escape 262 and West Bend Axe and Escape.
I certify that I understand this activity has potential risks including but not limited to:
1) Mental stress and anxiety
2) Falling or tripping, contact and/or crashes with other participants, defective equipment, and the condition of the room.
In consideration of permitting me to participate in this cool activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me, THE FOLLOWING ENTITIES OR PERSONS: The directors, officers, owners, employees, volunteers, representatives, and agents of any and all entities authorizing this activity;
(B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise.
I certify that I have no physical or mental illness that precludes my participation in a safe manner for myself or others. I am not under the influence of drugs or alcohol which impairs my ability to maintain my safety awareness or endangers others.
I acknowledge that this Accident Waiver and Release of Liability Form will be used by Team Escape 262 and West Bend Axe and Escape, organizer of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity. I agree that all staff or authorized agents may, in their sole discretion, determine it is unsafe for myself or others for my participation to continue, remove me from the premises by any lawful means.
I acknowledge that the directors, officers, owners, employees, volunteers, representatives, and agents of any authorizing entity are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf.
I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity. The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
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.
The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
-Participating in an event with/at Team Escape 262 and West Bend Axe and Escape will allow them to photograph me and use my likeness online or in marketing materials.
Falls Axe and West Bend Axe and Escape Waiver and Release of Liability Form
Team Escape 262 and West Bend Axe and Escape, for themselves, their present and former parent, subsidiaries, affiliates and related companies and each of their respective present and former directors, officers, shareholders, employees, volunteers, servants, agents, administrators, trustees, successors and assigns and any party or parties who claim a right or interest through them (hereinafter, the “Releasees”); Recreational Axe-Throwing (the “Activity”) This Participation Agreement and Waiver and Release of Liability is entered into between the undersigned “Participant” and Team Escape 262 and West Bend Axe and Escape, its directors, owners, employees, volunteers, and facilities and the owners and lessors thereof, hereinafter referred to as Team Escape 262 and West Bend Axe and Escape or collectively as “Releasees”). Participation in the activities of Team Escape 262 and West Bend Axe and Escape can be HAZARDOUS AND PRESENT A DANGER TO PARTICIPANT. If at any time the Participant believes conditions to be unsafe, he/she will immediately discontinue further participation in the Activities.
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1. Release of Liability, Waiver of Claims and Assumption of Risks * BY SIGNING THIS DOCUMENT, YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE OR CLAIM COMPENSATION. PLEASE READ THIS DOCUMENT CAREFULLY AND IN ITS ENTIRETY! In consideration for participating in the Activity on the date as set out below, which consideration is hereby expressly accepted and acknowledged, myself as the Participant, I HEREBY RELEASE, ACQUIT, AND FOREVER DISCHARGE, WITHOUT QUALIFICATION OR LIMITATION AND HOLD HARMLESS the
Releasees from any and all claims I may now and/or in the future may have against the Releases, and from any and all liability, for any personal injury, death and/or property damage, expense, and/or loss sustained by the Participant, incurred on his/her account as a result of the Participant’s participation in the Activity due to any cause whatsoever, including but not limited to and without limitation, negligence, gross negligence, willful misconduct, including the failure to take reasonable steps to safeguard or protect the myself, risk, dangers, and/or hazards of participating in the Activity, and/or breach of statutory or other duty, including duties arising from occupier's liability legislation and further agrees that if, despite this release, the Participant or any other person makes a claim on the Participant’s behalf against any of the Releasees, THE UNDERSIGNED WILL INDEMNIFY, SAVE AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LIABILITY,
LITIGATION EXPENSES, ATTORNEY FEES, LOSSES, DAMAGES OR COSTS ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM, WHETHER ASSERTED BY THE UNDERSIGNED, THE PARTICIPANT, OR ANOTHER PERSON.
2. THE PARTICIPANT ACKNOWLEDGES AND ACCEPTS that the Activity is inherently risky and dangerous and exposes the Participant to the possibility of personal injury, death, property damage and/or loss resulting therefrom. Risks may arise out of contact and/or participation with other participants, equipment and other mishaps. Risks may be caused by the Participant’s own actions, or inaction, the actions or inaction of others participants, the condition of the facilities in which the Activities take place, and/or THE NEGLIGENCE OF THE “RELEASEES.” Some Risks cannot be predicted or controlled. There may be other risks and social and economic losses either not known to me or not readily foreseeable at this time.
3. IT IS AGREED AND UNDERSTOOD that if the Participant commences such an action, or takes such proceedings, and the Releasees are added to such proceeding in any manner whatsoever, whether justified in law or not, the Participant will immediately discontinue the proceedings and/or claims. This Release of Liability, Waiver, and Assumption of Risk shall operate conclusively as an estoppel in the event of any claim, action, complaint or proceeding which might be brought in the future by the Participant with respect to the matters covered by this Release of Liability, Waiver, and Assumption of Risk. This Release of Liability, Waiver, and Assumption of Risk may be pleaded in the event any such claim, action, complaint or proceeding is brought, as a complete defense and reply, and may be relied upon in any proceeding to dismiss the claim, action, complaint or proceeding on a summary basis and no objection will be raised the Participant in any subsequent action that the other parties in the subsequent action were not privy to formation of this Release.
4. THE PARTICIPANT HEREBY AGREES that this Release of Liability, Waiver, and Assumption of Risk will be governed by applicable local Laws and that any dispute arising from this Release of Liability, Waiver, and Assumption of Risk will be adjudicated by the State of Wisconsin.
5. SEVERABILITY: If any provision of this document is determined to be invalid for any reason, such invalidity shall not affect the validity of any of the other provisions, which other provisions shall remain in full force and effect as if this document had been executed with the invalid provision eliminated.
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PHOTOGRAPHS, VIDEOS AND RECORDINGS: I release all photos taken of me at Team Escape 262 and West Bend Axe and Escape. I acknowledge that Team Escape 262 and West Bend Axe and Escape will own such “Images” and further grant Team Escape 262 and West Bend Axe and Escape permission to copyright, display, publish, distribute, use, modify, print and reprint such Images in any manner whatsoever related to Team Escape 262 and West Bend Axe and Escape business, including without limitation, publications, advertisements, brochures, web site images, or other electronic displays and transmissions thereof.
I further waive any right to inspect or approve the use of the Image by Team Escape 262 and West Bend Axe and Escape prior to its use. I forever release and hold Team Escape 262 and West Bend Axe and Escape harmless from any and all liability arising out of the use of the Images in any manner or media whatsoever, and waive any and all claims and causes of action relating to use of the Images, including without limitation, claims for invasion of privacy rights or publicity
EMAIL ADDRESS: By providing my e-mail address, I am opting into the e-mailing list. my e-mail address may be used to contact me but will not be made available to third parties.
LOST/ STOLEN ITEMS: We are not responsible for lost or stolen items.
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Bottom of Form, THE UNDERSIGNED PARTICIPANT, HEREBY CERTIFY THAT I AM AT LEAST 18 YEARS OLD, OR I AM THE LEGAL PARENT OR GUARDIAN OF PARTICIPANT. THAT I HAVE COMPLETELY READ AND UNDERSTAND THIS AGREEMENT AND ITS TERMS. THAT PRIOR TO SIGNING THIS AGREEMENT, I THE OPPORTUNITY TO ASK ANY QUESTIONS ABOUT THIS AGREEMENT. I AM AWARE THAT BY SIGNING THIS AGREEMENT I ASSUME ALL RISKS. I WAIVE AND RELEASE CERTAIN RIGHTS THAT I AND EACH OF MY HEIRS, NEXT OF KIN, FAMILY, RELATIVES, GUARDIANS, CONSERVATORS, EXECUTORS, ADMINISTRATORS, TRUSTEES AND ASSIGNS MAY HAVE AGAINST RELEASEES.