Riverbend Axe Throwing Waiver and Release of Liability

First Namerequired
Last Namerequired
Date of Birthrequired
Emailrequired
Phone (Digits Only)required

Addressrequired
Cityrequired
Staterequired
Ziprequired

Emergency Contact Nametextrequireddb save
Contact Relationshiptextoptionalnot save
Contact Phonenumberrequireddb save

I, [ First Name ] [ Last Name ], desire to participate in the activity of axe throwing on the date as set out below and future dates until my waiver is withdrawn, which has been organized by the Releasee(s). In consideration for being allowed to participate in this Activity on the date as set out below, which consideration is hereby expressly accepted and acknowledged, on behalf of myself, my representatives, heirs, agents administrators, trustees, executors, assigns, successors and on behalf of any party or parties who claim a right or interest through me (hereinafter, the “Releasor”), I HEREBY RELEASE, ACQUIT, AND FOREVER DISCHARGE, WITHOUT QUALIFICATION OR LIMITATION the Releasee(s) from any and all claims I may now and/or in the future may have against the Releasee(s), and from any and all liability, for any personal injury, death and/or property damage, expense, and/or loss sustained by me as a result of my 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 me from the 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.

THE RELEASOR ACKNOWLEDGES AND ACCEPTS that the Activity is inherently risky and dangerous, and there is the possibility of personal injury, death, property damage and/or loss resulting therefrom.

THE RELEASOR AGREES AND UNDERSTANDS that in order to participate in the Activity on the date set out below, he/she must agree to be bound by the terms of this Release of Liability, Waiver and Assumption of Risk.

THE RELEASOR AGREES that he/she will be fully responsible for all costs and expenses that may be incurred in providing any special services to him/her, outside of regular services agreed to or provided by the Releasee(s) in connection with the Activity, and without limiting the generality of the foregoing, agrees to be responsible for, and to pay for any and all costs relating to special travel, medical attention, or other special outlay for him/her personally, and to reimburse the Releasee(s) for all costs of these services as may be incurred by them for his/her benefit or at his/her request.

THE RELEASOR HEREBY confirms that by executing this agreement, he/she is representing that he/she is of the full age of majority and that he/she has read, and understands, this agreement. The Releasor acknowledges that he/she is not under the influence of any substances, including alcohol, illicit drugs, or prescription drugs, which may affect or impair his/her motor skills, judgment, or general ability to think clearly.

IT IS AGREED AND UNDERSTOOD that the Releasor will not make any claim or take any proceedings against any other person or corporation who might claim, in any manner or forum, contribution or indemnity in common law or in equity.

IT IS AGREED AND UNDERSTOOD that if the Releasor commences such an action, or takes such proceedings, and the Releasee(s) are added to such proceeding in any manner whatsoever, whether justified in law or not, the Releasor will immediately discontinue the proceedings and/or claims, and the Releasor will be jointly and severally liable to the Releasee(s) for the legal costs incurred in any such proceeding, on a substantial indemnity basis. 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 Releasor 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 defence 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 by the Releasor in any subsequent action that the other parties in the subsequent action were not privy to formation of this Release.

THE RELEASOR ACKNOWLEDGES that this Release of Liability, Waiver, and Assumption of Risk contains the entire agreement between the parties hereto, that the terms of this Release of Liability, Waiver, and Assumption of Risk are contractual, are not a mere recital, and any breach of these terms may be enforced against the Releasor, and may give rise to a damage claim against the Releasor enforceable by a further legal proceeding. The Releasor further acknowledges that the Releasee(s) have not made any oral, written or visual representations or statements that are not otherwise reflected in this agreement.

THE RELEASOR HEREBY AGREES that this Release of Liability, Waiver, and Assumption of Risk will be governed by the Laws of the State of Illinois or Missouri and that any dispute arising from this Release of Liability, Waiver, and Assumption of Risk will be adjudicated by the court of jurisdiction in the appropriate location and the Releasor hereby attorns to the exclusive jurisdiction of this Court for this purpose.

PHOTOGRAPHS, VIDEOS AND RECORDINGS I hereby grant Riverbend Axe Throwing, its managers, employees, and owners (collectively) non-revocable permission to capture my image and likeness in photographs, videotapes, recordings, or any other media (collectively “images”). I acknowledge that All-American Axe Throwing will own such images and further grant Riverbend Axe Throwing permission to copyright, display, publish, distribute, use, modify, print and reprint such images in any manner whatsoever related to said 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 prior to its use.


Date: 17.06.2020

Time: 3:32 AM

Signaturerequired
Tap to Sign

Parent/Legal Guardian (if Participant is under 18)

Parent/Legal Guardian Nametextoptionalnot save
Relationshiptextoptionalnot save
Parent/Legal Guardian Signatureoptionalnot save
Tap to Sign

Date: 17.06.2020

Time: 3:32 AM


I would like to get a copy of this document. I confirm my email address is spelled correctly.
I agree to Waiver Master Terms & Conditions and Privacy Policy available at waivermaster.com/terms.html and waivermaster.com/privacy.html.

By clicking/tapping/touching/selecting or otherwise interacting with the "Submit" button below, you are consenting to signing this Document electronically. You agree your electronic signature ("E-Signature") is the legal equivalent of your manual signature on this Document. You consent to be legally bound by this Document's agreement(s), acknowledgement(s), policy(ies), disclosure(s), consent term(s) and condition(s). You consent to be legally bound by Waiver Master's policies, terms and conditions available at waivermaster.com/terms.html and waivermaster.com/privacy.html . You agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature. You may request a paper version of an electronic record by writing to us. We reserve the right to charge a reasonable fee for the production and mailing of a paper version of the record. Your current valid email is required for all communications.




Submission Sequence: 2020-06-19T05:51:08.193Z4193
DUUID Sequence: LZJT74LXY7T_820a1050-74ed-4c33-8155-50bdc84aad65
IP(s): 35.129.32.101, 64.252.169.163
CFID: s2fuWjkP3CWyLpOoxvI7n7oTk86ndf_wDblUdpqCLV6XvdQ8FS988A==
TRACEID: Root=1-5eec524c-ef5ad81d6087f924b2739840
UA: Mozilla/5.0 (X11; CrOS x86_64 13020.67.0) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/83.0.4103.97 Safari/537.36