Accident Waiver And Release Of Liability Form printable pdf download

ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM

Must be signed by parent or legal guardian for any participant under 18 years of age.

Race/LA dba Escape Room LA

120 E. 8th Street, Los Angeles CA 90014

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL

ACTIVITIES ASSOCIATED WITH THIS ESCAPE THE ROOM EVENT, including by

way of example and not limitation, any risks that may arise from negligence or

carelessness on the part of the persons or entities being released, from dangerous

or defective equipment or property owned, maintained, or controlled by them, or

because of their possible liability without fault.

I certify that I understand this activity has potential risks including but not limited to:

Use of simple tools;

Potentially moving or lifting objects of not more than 20 pounds;

Mental stress and anxiety;

Being in an enclosed space with up to 12 other persons;

Possibility of failure to escape the room in the allotted time.

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 the organizers 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.

In consideration of my application and permitting me to participate in this 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, 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 acknowledge that the directors, officers, employees, volunteers, representatives, and

agents of any authorizing entity are NOT responsible for the errors, omissions, acts,

continued...

Accident Waiver And Release Of Liability Form