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Flip Side Ninja Park, LLC

Waiver and Release of Liability

Today's Date: July 18, 2018, 

1. In consideration of being permitted to enter the premises, use the facilities, obstacles, related equipment and/or observe or participate in any way in FLIP SIDE NINJA PARK, LLC (“Flip Side Ninja Park”) programs, events or activities whether on or off the premises (“Activity”), I, for myself, my heirs, estates, executors, representatives, administrators and assignees:

 

2. ACKNOWLEDGE, agree, and represent that I understand the nature of the Activity and that I am qualified, in good health, and in proper physical condition to participate in such Activity and do not know of any condition or reason I should not participate in the Activity.  I further agree and warrant that if, at any time, I believe the conditions to be unsafe, I will immediately discontinue further participation in the Activity. I agree to allow Flip Side Ninja Park to use any pictures or video taken of me participating in activies for social media posts or advertising.

 

3. AGREE that my safety is primarily my own responsibility.  I agree to make sure that I know how to safely participate in the Activity, and I agree to observe any rules and practices that may be employed to minimize the risk of injury.  I agree to stop and seek assistance if I do not believe I can safely continue, to limit my participation to reflect my personal fitness level, and to refrain from any and all actions that would pose a hazard to myself or others.

 

4. FULLY UNDERSTAND that:

(a)THIS ACTIVITY INVOLVES RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING THE POTENTIAL FOR DISABILITY, PARALYSIS, AND DEATH (“Risks”) and while particular rules, equipment, and personal discipline may reduce these Risks, these Risks of serious injury do exist. (b)These Risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the Activity, the conditions in which the Activity takes place and/or THE NEGLIGENCE OF THE RELEASEES; (c)There may be OTHER RISKS and/or SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time. 

 

4. RECOGNIZE AND ACKNOWLEDGE THAT FLIP SIDE NINJA PARK, LLC DOES NOT CARRY ANY TYPE OF ACCIDENT OR HEALTH INSURANCE POLICY ON THE PARTICIPANTS IN THE ACTIVITY and that injuries can be catastrophic for those without proper medical coverage.

 

5. KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation in the Activity.

 

6. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE FLIP SIDE NINJA PARK, LLC, its affiliates, owners, directors, agents, officers, managers, partners, members, volunteers, employees, other participants, and its attorneys (“Releasees”) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED, OR ALLEGED TO BE CAUSED, IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE TO THE FULLEST EXTENT PERMITTED BY ARKANSAS LAW, INCLUDING NEGLIGENT RESCUE OPERATIONS; I FURTHER AGREE that if, despite this WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, I, or anyone on my behalf, make a claim against any of the Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which may be incurred as the result of such claim; AND I FURTHER AGREE that all disputes arising out of, relating to, or in connection with this agreement, including any question regarding its existence, validity, or termination, shall be finally resolved by arbitration, with the place of arbitration being Benton County, Arkansas, and the cost of said arbitration being my full responsibility.

 

I ACKNOWLEDGE THAT I AM AGE 18 OR OLDER, HAVE READ THIS AGREEMENT AND FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE, AND I INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID, THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.

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*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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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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Emergency Contact

Emergency Contact's 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.
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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