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Smash Brothers Rage Room Waiver and Release of Liability

In consideration of participating in the “Rage Room” activity as well as utilizing the services, equipment, and/or facilities of Smash Buffalo LLC (“Smash Brothers Rage Room”), I hereby acknowledge and agree to the following terms and conditions:

 

ASSUMPTION OF RISK:

 

I hereby acknowledge, accept and agree that the use of and/or participation in a “rage room” or “smash room” wherein participants willfully and deliberately either alone or with others, smash, damage and/or destroy pre-determined objects in a confined setting (“Destruction Room”), and the use of Smash Brothers Rage Room's ancillary services, equipment, and/or facilities (“Destruction Room Add-Ons”) is inherently dangerous and may result in serious bodily injury, including but not limited to dismemberment, permanent incapacitation and/or death. Participation in the Destruction Room will place unusual and atypical stresses on the body.   Accordingly, I understand and agree that if I suffer from any of the following conditions, I am expressly prohibited from participating in the Destruction Room:

 

Asthma and any other chronic respiratory disorders;
Epilepsy;
Cardio vascular and heart related disorders, including but not limited to hypertension,;
Skeletal, joint and/or ligament problems or conditions including any and all neck, head and/or back related issues;
Dizziness or vertigo; and
Any clinically diagnosed mental health issues, including but not limited to anger management problems.

 

(collectively “Disqualifying Medical Conditions”)

 

Also, women who are pregnant or may possibly be pregnant are expressly prohibited from participating in the Destruction Room.  Moreover, Smash Brothers Rage Room adheres to a strict sobriety policy and prohibits participation in the Destruction Room if any participant is under the influence of alcohol or any illegal substances and/or any prescribed medication which impairs judgment, responsiveness or which in any way inhibits physical ability in any manner whatsoever.

 

I understand that Smash Brothers Rage Room owners, operators and/or staff are not licensed medical personnel and will not necessarily be able to ascertain if I have a Disqualifying Medical Condition (including but not limited to pregnancy or intoxication/drug use).  I further understand and agree that if I participate in the Destruction Room while having a Disqualifying Medical Condition (including but not limited to pregnancy or intoxication/drug use) I am doing so at my own risk and any such unauthorized participation will immediately void any protection afforded me by virtue of this Agreement or otherwise under New York state law.

 

I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.
I further acknowledge that Smash Buffalo LLC has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.
I further acknowledge that Smash Buffalo LLC can not guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, staff, and other clients and their families.
I voluntarily seek services provided by Smash Buffalo LLC and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending my appointment.
I attest that:
* I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
* I have not traveled internationally within the last 14 days.
* I have not traveled to a highly impacted area within the United States of America in the last 14 days.
* I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.
* I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non contagious by state or local public health authorities.
* I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.
I hereby release and agree to hold Smash Buffalo LLC harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of Smash Brothers Rage Room, or that may otherwise arise in any way in connection with any services received from Smash Buffalo LLC. I understand that this release discharges Smash Buffalo LLC from any liability or claim that I, my heirs, or any personal representatives may have against the business with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from Smash Buffalo LLC. This liability waiver and release extends to Smash Buffalo together with all owners, partners, and employees.

  

I have received full information regarding the Destruction Room and the Destruction Room Add-Ons and have had the opportunity to ask any questions that I have regarding the same. I have full knowledge of the nature and extent of all the inherent risks associated with the Destruction Room and the Destruction Room Add-Ons, which may include but are not limited to :

 

Any and all manner of injury, including without limitation and the possibility of injury, incapacitation and/or death, resulting from use of the Destruction Room and/or the Destruction Room Add-Ons, including without limitation, slipping, tripping or falling on debris, whether on the floor or flying through the air or being hit with debris, injuries from equipment, being struck with  one’s own weapons or those of other participants, running into, bumping or colliding with other participants and/or debris, being struck or hit by other participants, their weapons and/or flying debris, failure to wear protective gear or failure to wear protective gear as instructed, permanent structures and/or fixtures becoming cracked, broken or dislodged and hitting, striking, tripping, crushing or falling on me, and/or any other consequence whatsoever of utilizing the Destruction Room and/or Destruction Room Add-Ons;

 

Injuries resulting from the actions or omissions of others, including any negligent conduct of Smash Brother officers, directors, staff and/or employees, including but not limited to slips, trips, falls of other participants and/or being hit or struck by other participants and/or flying debris;

 

Cuts, punctures, bone breaks, bruises, loss of limbs and/or abrasions resulting from contact with damaged items, debris, and/or any other surface, person, or equipment, weapon, debris, structural components of the Destruction Room;

 

Injuries resulting from shock, stress, falling, hitting, walking, running, slipping, tripping, crawling, jumping or any other movement;

 

The aggravation or worsening of any existing medical condition, whether known or unknown;

 

Failure or misuse of safety gear, weapons, or any other items or equipment;

 

Failure to follow Smash Brothers Rage Room owners, officers, directors, staff and/or employee instructions and/or failure to ask for reasonable information, assistance or guidance;

 

Any injury that may occur while moving into or out of the Destruction Room and/or the premises housing the Destruction Room, including but not limited to slips, trips, and falls and or being struck or hit by debris or other participants.

 

I further acknowledge that the above list is not inclusive of all possible inherent risks associated with the use the Destruction Room and the Destruction Room Add-Ons, and I agree that such list is for example purposes only and in no way limits the extent or application of this Assumption of Risk, Release and Indemnification Agreement (“Agreement”) and the possible injuries which may result from participating in the Destruction Room.

 

Release:

 

In consideration of my use of the Destruction Room and/or the Destruction Room Add-Ons, and/or participation in any program, competition, special event, group or party offered by or held at Smash Brothers Destruction Room, I hereby hold harmless, release and discharge Smash Brothers Rage Room, as well as its members, managers, officers, directors, owners, employees, staff, agents and contractors and assigns, (“Smash Brothers Releasees”) from any and all liabilities, suits, claims, causes of action, demands, damages, injuries, (including attorneys' fees and expenses), losses or costs of any nature whatsoever incurred by me or that are in any way related to or arising out of the use or intended use of the Destruction Room and/or Destruction Room Add-Ons, whether supervised or not, including, without limitation, all claims for property damage, personal injuries (including death), whether or not CAUSED BY THE NEGLIGENCE OF SMASH BROTHERS RAGE ROOM and/or the SMASH BROTHERS RAGE ROOM RELEASEES OR OTHERWISE.

 

Indemnification:

 

I hereby agree to defend, indemnify and hold harmless, Smash Brothers Rage Room and the Smash Brothers Rage Room Releasees, from any and all liabilities, suits, claims, causes of action, demands, damages, losses or costs of any nature whatsoever arising out of, or in any way related to, my use of or participation in the Destruction Room or the Destruction Room Add-Ons, whether or not CAUSED BY THE NEGLIGENCE OF SMASH BROTHERS RAGE ROOM and/or the SMASH BROTHERS RAGE ROOM RELEASEES.

 

I understand and agree that Smash Brothers Rage Room and the Smash Brothers Rage Room Releasees reserve the right at all times to deny access to its facilities to any individual, (permanently or for a specified period of time), whether prior to or during a Destruction Room session as well as for any breach of Smash Brothers' policies, rules and regulations, for any conduct that is viewed as unsafe or inappropriate, or for any other reason whatsoever, whether disclosed or not in Smash Brothers Rage Room's sole and absolute discretion.

 

While using Smash Brothers' Destruction Room and/or Destruction Room Add-Ons, I consent to Smash Brothers Rage Room capturing my image or likeness on any form of media  including but not limited to photographs and/or video and any and all social media applications and  I agree that any such media may be used for any and all purposes that Smash Brothers deems appropriate in its sole and absolute discretion.  I expressly waive my right to any intellectual property protection in my images and/or likeness including but limited to copyright and or trademark protection.  Smash Brothers Rage Room may add my email address to their mailing list for Smash Brothers Rage Room updates and promotions, however, I have the right to opt out of such participation.

 

This Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators and assigns, in the event of my death or incapacity. By signing this Agreement, I waive the right to bring a court action to recover damages or obtain any other remedy for any injury to myself or death, or any damages to my property, however caused, arising out of my use of or participation in the Destruction Room and/or the Destruction Room Add-Ons, now or any time in the future, whether or not CAUSED BY THE NEGLIGENT ACTS OF SMASH BROTHERS RAGE ROO RELEASEES or acts or omissions on the part of any other third parties. I agree to be solely responsible for any and all attorneys' fees and expenses incurred by Smash Brothers Rage Room as a result of any claims made by me or on my behalf in contravention of this Agreement.

 

I expressly represent and agree that I am at least 18 years of age and legally competent to sign this Agreement. This Agreement  shall be effective and binding upon me and upon my assigns, heirs, representatives, executors, and administrators. I expressly understand and agree that my participation in this activity is purely voluntary, and I elect to participate in spite of the risks set forth above. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or I otherwise agree to bear the costs of such injury or damage. I further certify that I have no medical or physical conditions which interfere with my ability to participate safely in the use of the Destruction Room and/or the Destruction Room Add-Ons including any Disqualifying Medical Condition, pregnancy or intoxication.

 

I agree that the validity and enforceability of this Agreement will be governed by the laws of the State of New York, without regard to its conflict of law rules, and venue for any proceedings regarding this Agreement shall be in the State courts located in Niagara County, New York. I agree that if any portion of this Agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.

 

I ENTER THIS AGREEMENT WILLINGLY AND FREELY WITHOUT ANY DURESS OR COERCION  I HAVE READ THIS AGREEMENT IN ITS ENTIRETY AND HAVE HAD THE OPPORTUNITY TO ASK ANY AND ALL QUESTIONS I MAY HAVE REGARDING THIS AGREEMENT AND/OR MY PARTICIPATION IN THE DESTRUCTION ROOM AND/OR THE DESTRUCTION ROOM ADD-ONS. 

 

 

Participants Signature:

(Participants must be 18 years of age to sign)

 


     I agree that I will be responsible for damage as a result of throwing items or using striking instruments directly against drywall, chalkboard, ceiling, table, lights or speakers.

 

 

 

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*
Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
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

First Name*

Middle Name

Last Name*

Phone*
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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