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Waiver and Release of Liability Form 

Today's Date: January 25, 2020

THIS AGREEMENT CONTAINS A WAIVER OF IMPORTANT LEGAL RIGHTS, PLEASE READ CAREFULLY.

WARNING : THESE GAME ACTIVITIES SIMULATE DANGEROUS AND HIGHLY STRESSFUL SITUATIONS MEANT TO TEST A PERSON'S PHYSICAL AND MENTAL LIMITS WHICH MAY CAUSE MENTAL AND PHYSICAL DURESS OR INJURY. BY SIGNING THIS AGREEMENT YOU ARE CONSENTING TO WAIVE VALUABLE LEGAL RIGHTS TO SUE FOR ANY INJURY RESULTING FROM YOUR PARTICIPATION IN ANY GAME ACTIVITY, EPIC ESCAPE GAMES LLC'S SUPERVISION OF ANY GAME ACTIVITIY, ANY EQUIPMENT INVOLVED IN ANY GAME ACTIVITY, OR ANY OTHER PARTICPANTS IN ANY GAME ACTIVITY. View electronically at www. .com

In consideration of Epic Escape Games LLC allowing me to participate in a game activity, which shall be defined as an activity designed to simulate a dangerous and highly stressful situation, I, the undersigned, do hereby represent and warrant that :

  1. I ASSUME ANY AND ALL RISKS of participating in any game activity conducted by Epic Escape Games LLC and agree to fully and forever release, indemnify, and hold harmless Epic Escape Games LLC.
  2. I understand that this release includes, but is not limited to, any risk that may arise from the negligence, act, omission, or carelessness on the part of Epic Escape Games LLC from dangerous or defective equipment or property owned, maintained, or controlled by Epic Escape Games LLC.
  3. I understand that Epic Escape Games LLC includes all of it's employees, assigns, directors, members, volunteers, representatives, affiliates, insurers, subcontractors, and all other persons acting on behalf of Epic Escape Games LLC.
  4. I understand Epic Escape Games LLC conducts simulated game events which are meant to test a person's physical and mental limits which may cause stress and injury; I represent and warrant that I am sufficiently physically fit, for participation may exacerbate or initiate physical stress or injury, up to and including disability or death, by assuming any and all risks of participation.
  5. I understand that Epic Escape Games LLC conducts simulated game events which may be disturbing. I represent and warrant that I am of sufficient mental capability and have no pre-existing mental or psychiatric conditions, such as, but not limited to, anxiety, panic attacks, claustrophobia, or any other condition that may cause mental duress or damage of any character by my participation in a simulated event. Furthermore, I understand that my participation my exacerbate or initiate mental or psychiatric conditions and I fully and forever release and agree to indemnify Epic Escape Games LLC for any damage to or loss of my personal property resulting from my participation.
  6. I understand that my participation may result in damage to or loss of my personal property and hereby, fully and forever, release and agree to indemnify Epic Escape Games LLC for any damage to or loss of my personal property resulting from my participation.
  7. I fully and forever waive, release, and discharge Break Out LLC of any and all liability, claims, loss, expenses, demands, actions, and causes of actions whatsoever arising from my participation in any game activities.
  8. I agree on behalf of myself, my heirs, executors, administrators, agents and assigns to fully and forever, release and agree to indemnify Epic Escape Games LLC from any and all liability, claims, loss, expenses, demands, actions, and causes of actions, whatsoever, which may be initiated by myself or any other person or organization, arising from any negligence, act, omission, or carelessness by Epic Escape Games LLC.
  9. I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers and assigns. I would like to receive free email promotions and discounts to the email address provided below. I may unsubscribe from emails and emails from us any time.
  10. I acknowledge that this Accident Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under the applicable law.
  11. If any provision of this agreement is deemed invalid or unenforceable, all other provisions shall continue in full force and effect.

I CERTIFITY THAT I HAVE READ THIS DOCUMENT. I FULLY UNDERSTAND IT'S CONTENT, AND AM NOT UNDER THE INFLUENCE OF ANY SUBSTANCE WHICH MAY ALTER MY ABILITY TO UNDERSTAND IT'S CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL. I FURTHER CERTIFIY THAT I AM 18 YEARS OF AGE OR OLDER, OR THAT MY PARENTS OR LEGAL GUARDIAN'S SIGNATURE IS BELOW.

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
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*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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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