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Back40Battles, LLC Release and Waiver of Liability and Indemnity Agreement

(Read Carefully Before Signing)

 

In consideration of the services of Back40Battles LLC, its agents, owners, officers, representatives, employees, volunteers, participants, parent, sister or subsidiary corporations (hereinafter collectively known as B40BLLC), I hereby agree to release and discharge B40BLLC on behalf of myself, my parents, my heirs, assigns, personal representative and estate as follows:

Inherent Risks: I acknowledge that any outdoor activity entails known and unanticipated risks that could result in physical or emotional injury, death, or damage to myself, to property, or to third parties. I also understand and acknowledge that failing to properly use equipment increases risk of injury while participating in these activities.

Express Assumption of Risk: As lawful consideration for being allowed to participate in activities offered by B40BLLC, I expressly agree and promise on behalf of myself and any of the minors for which I am responsible, to accept and assume all the risks existing in this activity. My/our participation in this activity is purely voluntary, and I/we elect to participate in spite of the risks.

Indemnity: Should B40BLLC or anyone acting on their behalf be required to incur attorney's fees and costs to enforce this agreement, I agree on behalf of myself and any of the minors for which I am responsible to indemnify and hold them harmless for all such defense fees and costs.

Personal Condition & Insurance: I certify that I/we have no medical, mental or physical conditions which could interfere with my/our safety or ability to participate in these activities, or else I/we are willing to assume and bear the cost of all risks that may be created, directly or indirectly, by any such condition. I/we further certify that I/we have adequate insurance to cover any injury, damage or emergency transportation or search and rescue costs I/we may cause or suffer while participating, or else agree to bear the costs of such injury, damage or emergency transportation costs ourselves.

Photographic Assignment: I grant to B40BLLC, its representatives and employees, on behalf of myself and any of the minors for which I am responsible the right to take photographs or film (of whatsoever nature) records of any or all of its activities and on behalf of myself and any of the minors for which I am responsible I/we hereby agree that B40BLLC may use such records for promotional and/or commercial purposes without any remuneration to me. I/we hereby assign all right, title and interest I/we may have in or to any and all media in which my name, image or likeness might be used by B40BLLC. I/we agree that B40BLLC may use such photographs and video for any lawful purpose, including for example such purposes as publicity, illustration, advertising and web content.

Legal Responsibility for Minor & Age Certification: I certify that I am over the age of 18 years and that I am the parent or guardian with legal responsibility for any minors listed on this document. I certify that the minors for which I am responsible have correctly provided their age and all of those minors are over 7 years old in age.

By signing this document, I acknowledge for myself and any of the minors, for which I am responsible and give representation for, is hurt or property is damaged during my/our/their participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against B40BLLC on the basis of any claim from which I have released them herein.

I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT, AND I AGREE TO BE BOUND BY ITS TERMS.

 

I Agree

Date: July 18, 2018

First Participant's Name

First Name*

Last Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's Date of Birth*
Participant's 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*
Join our mailing list and stay informed on our upcoming events, discounts and promotions.
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
Event Information:

What is the date of your laser tag event. *

Who is hosting your laser tag event (First, Last Name or Business Name)? *
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.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

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. 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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