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47420 State Hwy-26

Suites 90 & 87

Houghton, MI 49931

WAIVER AND RELEASE OF LIABILITY

Assumption of Risks, Release of Liability, Waiver of Claims and Media Release

In consideration of the risk of injury while participating in 906 Virtual Reality, LLC (DBA 906VR) – Events (the “Activity”), and as consideration for the right to participate in the Activity, I hereby, for myself, my heirs, executors, administrators, assigns or personal representatives, knowingly and voluntarily enter into this waiver and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in this Activity, and do hereby release and forever discharge 906 Virtual Reality, LLC (DBA 906VR) located at 47420 State Hwy-26, Suites 90 & 87, Houghton, MI 49931, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economic or emotional loss, that I may suffer as a direct result of my participation in the aforementioned activity.

 

I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, TEMPORARY OR PERMANENT DISABILITY, EXPOSURE TO COMMUNICABLE DISEASES, ECONOMIC OR EMOTIONAL LOSS, AND DEATH. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS’ NEGLIGENCE, OR THE CONDITION OF THE ACTIVITY LOCATION(S). NONETHELESS, I ASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY.

 

I agree to indemnify and hold harmless 906 Virtual Reality, LLC (DBA 906VR) against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney’s fees and any related costs, if litigation arises pursuant to any claims made by me or by anyone else acting on my behalf. If 906 Virtual Reality, LLC (DBA 906VR) incurs any of these types of expenses, I agree to reimburse 906 Virtual Reality, LLC (DBA 906VR).

 

I acknowledge that 906 Virtual Reality, LLC (DBA 906VR) and their directors, officers, volunteers, representatives and agents are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of 906 Virtual Reality, LLC (DBA 906VR).

 

I ACKNOWLEDGE THAT THIS ACTIVITY MAY INVOLVE A TEST OF A PERSON’S PHYSICAL AND MENTAL LIMITS AND MAY CARRY WITH IT THE POTENTIAL FOR DEATH, OR SERIOUS INJURY. The risks may include, but are not limited to, those caused by facilities, equipment and action of others, including but not limited to, participants, volunteers, spectators, event officials and event monitors, and/or producers of the event.

I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS “WAIVER AND RELEASE” AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE 906 Virtual Reality, LLC (DBA 906VR) AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, SUCCESSORS AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST 906 Virtual Reality, LLC (DBA 906VR). FOR PERSONAL INJURY.

 

To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence on the part of 906 Virtual Reality, LLC (DBA 906VR), its agents, and employees.

 

In the event that I should require medical care or treatment, I agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance.

 

In the event that any damage to equipment or facilities occurs as a result of my willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any actions of neglect or recklessness. This agreement was entered into at arm’s-length, without duress or coercion, and is to be interpreted as an agreement between parties of equal bargaining strength. Both the Participant, and 906 Virtual Reality, LLC (DBA 906VR) agree that this Agreement is clear and unambiguous as to its terms, and that no other evidence will be used or admitted to alter or explain the terms of this Agreement but that it will be interpreted based on the language in accordance with the purposes for which it is entered into.

 

In the event that any provision within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the clause severed does not affect the intent of the parties. If a court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written construed and enforced as so limited.

 

I will NOT use the virtual reality equipment:

  1. If I have any communicable or infectious disease or illness, skin disorder, largecuts, open sores or wounds; 
  2. If I am under the influence of alcohol or drugs; 
  3. If I am epileptic, unless in the opinion of my physician, my epilepsy is under medical control so that I am in sufficient control of my seizures not to endanger myself.

 

I understand that any items I bring to 906 Virtual Reality, LLC (DBA 906VR), including, but not limited to: camera, MP3 player, cell phone, other personal electronics, jewelry, glasses, etc., are the responsibility of myself, and 906 Virtual Reality, LLC (DBA 906VR) is in no way responsible for lost, missing, stolen or damaged items.

 

By entering 906 Virtual Reality, LLC (DBA 906VR) location or premises, I authorize 906 Virtual Reality, LLC (DBA 906VR) to use the following personal information:

  1. My picture - including photographic, motion picture, and electronic (video) images.
  2. My voice - including sound and video recordings.

I hereby grant 906 Virtual Reality, LLC (DBA 906VR), its subsidiaries, successors and assignees, the right to use, publish, and reproduce, for all purposes, my name, pictures of me in film or electronic (video) form, sound and video recordings of my voice, and printed and electronic copy of the information described in sections (1) and (2) above in any and all media including, without limitation, cable and broadcast television and the Internet, and for exhibition, distribution, promotion, advertising, sale, press conferences, meetings, hearings, educational conferences and in brochures and other print media.

 

This permission extends to all languages, media, formats and markets now known or hereafter devised. This permission shall continue forever. I further grant 906 Virtual Reality, LLC (DBA 906VR) all right, title, and interest that I may have in all finished pictures, negatives, reproductions, and copies of the original print, and further grant 906 Virtual Reality, LLC (DBA 906VR) the right to give, sell, transfer, and exhibit the print in copies of facsimiles thereof, for marketing, communications, or advertising purposes, as it deems fit.

By entering 906 Virtual Reality, LLC (DBA 906VR) premises, I hereby waive the right to receive any payment for signing this release and waive the right to receive any payment for 906 Virtual Reality, LLC (DBA 906VR) use of any of the material described above for any of the purposes authorized by this release. I also waive any right to inspect or approve finished photographs, audio, video, multimedia, or advertising recordings and copy or printed matter or computer generated scanned image and other electronic media that may be used in conjunction therewith or to approve the eventual use that it might be applied. I acknowledge that I have read the foregoing and I fully understand the contents. I also certify that in the event I am signing on behalf of a minor who is under the age of eighteen years, to whom this release applies and that I have the legal authority to execute this release, I approve the foregoing and agree that we shall be bound thereby. 

 

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

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Permission for Game Ratings
Our game library includes games rated from Everyone to Mature. If you would like your game experience curated to exclude Mature rated games, please indicate below. (Mature games may include Gore, Language or Scary Images)
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Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

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Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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