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MEMBERSHIP, TRAINING, AND FACILITY USE AGREEMENT

THIS AGREEMENT CONTAINS IMPORTANT LIMITATIONS ON YOUR RIGHTS. PLEASE READ THIS AGREEMENT CAREFULLY.  YOUR ASSENT TO ALL TERMS OF THIS AGREEMENT IS A CONDITION TO YOUR ENTRY TO AND USE OF THE FACILITY. YOU UNDERSTAND THAT YOU CAN CHOOSE NOT TO SIGN THIS AGREEMENT AND NOT TO ENTER THE FACILITY.

INPAX ACADEMY, LLC (“INPAX”) is dedicated to personal security and firearms training in a safe, constructive, and friendly environment.  Safety is paramount when handling firearms, and INPAX strives to ensure through rigorous enforcement of the following Rules that all persons handle and use firearms in a safe manner.

However, no matter how strictly safety rules are written and enforced, personal security training and firearm handling and use involve certain inherent risks, including bodily injury and death.  Safety rules may mitigate such risks but can never eliminate those risks.

By using INPAX services or entering INPAX property, including without limitation, it’s indoor/outdoor range(s), training grounds, and any other locations at which INPAX may provide training and any other services (collectively, the “Facility”) you assume all risks of any nature, including, but not limited to, in relation to firearm handling and use by you and others at the Facility.  Accordingly, you are required to read carefully, fully understand, and execute the following INPAX Membership, Training, and Facility Use Agreement (the “Agreement”).  While you must read this entire Agreement carefully, here are the key provisions.

The Agreement:

  • Sets out the Rules for the Facility, which you acknowledge that you have read, understand, and agree to follow.
  • Confirms that you assume all risk of any nature by entering the Facility, including, but not limited to, to assuming the risk that INPAX may be negligent or that third parties may be negligent.
  • Requires that you release and agree not to sue INPAX for any injury or damage you cause or suffer, even if caused by the negligence of INPAX.
  • Requires that you indemnify (i.e., that you will be legally and financially responsible) INPAX for any injuries or damages that you cause or suffer, even if caused by the negligence of INPAX.
  • Confirms that you consent to audio and audiovisual monitoring while at the Facility, and that, if applicable, you consent to the use of your image in connection with INPAX internal, marketing, and training materials.
  • Informs you that INPAX’s Property is within 1000 feet of a school; thereby, subjecting you to the Gun-Free School Zone Act when traveling to and from INPAX.

TERMS

Claims: any and all legal claims, lawsuits, causes of action, damages, expenses, injuries or costs. This includes, but is not limited to, claims for intentional acts, negligence, nuisance, noise, damage/theft/loss/destruction of personal property, or any other legal claim that is cognizable in a state or federal court of law, regardless of whether related to your participation in activities offered by or use of the Property of INPAX.

Limitations: physical, mental, emotional or other limitations, disabilities, illnesses, injuries or conditions.

Property: Any property of any form, tangible or intangible, including real estate, buildings, erections, Range, goods, products, firearms, ammunition, or any object owned, leased or rented, whether wholly or partially, by INPAX.

Range: any and all shooting, training and practice ranges, including, but not limited to, firing ranges, tactical/dynamic ranges, virtual ranges and simulators, combatives training range and shoot house, whether used for lethal, non-lethal or virtual fire or training, in any capacity.

INPAX: INPAX Academy, LLC and its respective officers, officials, directors, members, owners, shareholders, employees, representatives, agents, event and stage coordinators and designers, training personnel and directors, firearm and safety instructors, attorneys, insurers, sponsors, vendors, lessors, renters, affiliates, successors, assigns, and any legal entity having any interest or right in any Property utilized by INPAX.

GUN-FREE SCHOOL ZONE ACT

INPAX’s Property is located within 1000 feet of a school zone; thereby, subjecting you to the Gun-Free School Zone Act. Pursuant to federal law, while traveling in a school zone, all firearms, including silencers, must be unloaded and stored in a locked container, unless you possess a valid Pennsylvania License to Carry Firearms.  Federal law does not exempt you from compliance with the Gun-Free School Zone Act if you have a concealed carry permit or license from a state other than Pennsylvania. As Pennsylvania law prohibits INPAX from inquiring as to whether you have a Pennsylvania License to Carry Firearms, INPAX is placing you on notice of the close proximity of a school zone so that you can ensure your compliance with federal law.

By willingly, knowingly and voluntarily signing this Agreement, you agree to comply with the Gun-Free School Zone Act.

MEMBERSHIP ACCEPTANCE & FACILITY RULES AND REGULATIONS

The Facility is only for use by individuals who are not prohibited from owning, purchasing, possessing or using firearms under federal, state or local law.  By executing this Agreement, you swear and affirm, subject to the penalties of perjury and false swearing, including pursuant to 18 U.S.C. § 1621 and 18 Pa.C.S. § 4903, that (1) you are not prohibited from owning, purchasing, possessing or using firearms under federal, state or local law and (2) you have no unlawful, illegal, wrongful or otherwise deceitful intentions in executing this Agreement or in utilizing INPAX’s Property.

For all training you may receive from INPAX, you acknowledge and agree that: (1) all INPAX training methods, techniques, and strategies are valuable and confidential trade secrets of INPAX and improper use or demonstration of these methods, techniques, and strategies may result in injury; (2) you will not disclose any INPAX training methods, techniques, or strategies to any third party without INPAX consent; (3) you will not use or demonstrate any methods, techniques, and strategies learned through INPAX training except in connection with defensive use ONLY in protecting yourself or others from harm and not for any criminal, immoral, or malicious purpose; (4) that any training, guidance, advice, or suggestions of INPAX shall not be construed as legal advice, including on whether any particular action or inaction is justified or lawful under the law; and (5) that you will seek out competent legal advice for all legal questions and not rely on any statements made by INPAX

Given the highly sensitive nature of our training and services, INPAX reserves the right to refuse membership or access to anyone at any time and to restrict or revoke the membership privileges of any member at any time, in which occasion, you agree that any fees you have paid will not be refunded.

FIREARM SAFETY RULES

There are FOUR Primary Rules of firearm safety that INPAX follows and strictly enforces.  Those rules are:

RULE I:  ALWAYS Keep your gun pointed in a safe direction

Never point your muzzle at anything you are NOT willing to destroy, even if you feel the gun is unloaded.  A “safe” direction is situational and should always be evaluated.

RULE II:  ALWAYS keep your finger off the trigger until you are ready to shoot.

Your trigger finger should NEVER go onto the trigger until your sights are on target, and you have made the decision to shoot.  This includes during handling, moving, reloading, etc.

RULE III:  ALWAYS keep the firearm unloaded until ready to use.

Treat every firearm as if it is loaded. When handling any firearm, it should be treated as if it was loaded until you have cleared it.

RULE IV:  ALWAYS identify your target, it’s foreground and background.

Be aware of your target, what lies before it, after it, and around it.  You are responsible for every round you discharge, no matter where it goes.

FACILITY RULES

In addition to the four rules of safe firearm handling, the following Rules govern your conduct at the Facility at all times:

  1. All firearms must remain cased or holstered until you are in your firing lane or the Range Safety Officer advises that firearms may be handled.  When you leave your firing lane or upon instruction of your Range Safety Officer, you must re-case or re-holster all firearms.
  2. You must always wear appropriate eye and ear protection on the ranges, which you must put on before entering the range airlocks.  Failure to wear appropriate eye and ear protection may result in permanent loss of vision or hearing.
  3. You may dry-fire firearms only while in the firing lane and only with the firearm pointed downrange.
  4. Never hand a loaded firearm to anyone.  Set the firearm down on the bench with the action open and muzzle facing downrange at your firing lane, and allow the other person to pick it up and chamber a round.
  5. If you have a firearm malfunction, misfire, or jam, after waiting 10 seconds for a potential hangfire, set the firearm down with the muzzle pointed downrange and advise the Range Safety Officer immediately.
  6. Commercially loaded ammunition is recommended.  You are responsible for and assume the risk of using any hand-loaded ammunition.
  7. Only quality, fully jacketed or jacketed hollow point, ammunition is permitted for use at the Facility.  Any pistol ammunition that does not exceed .50 caliber may be used at the Facility, subject to the limitations in these Rules.  Rifle ammunition may not exceed 7.62x51mm/.308 caliber.  Unjacketed soft lead, steel core, tracer, armor piercing, incendiary, or shot-type ammunition is strictly prohibited.  If you have any questions regarding the appropriateness of your ammunition, please confirm with the Range Safety Officer.
  8. No cross-lane shooting.  If you shoot at anything other than your target in your lane, you will be removed from the Facility immediately without refund.
  9. If you cause any damage to any INPAX’s Property, you will be responsible for the entire cost to repair or replace such damaged property.
  10. You may only retrieve your own brass that lands behind the firing line.  Any brass that lands in front of the firing line becomes the property of INPAX upon landing.  You may pick up the brass of other users of the Facility only with their express prior consent, and only if it falls behind the firing line.  INPAX recommends the use of a brass catcher if collecting spent brass is important to you.
  11. INPAX defensive tactics training classes and courses frequently involve simulated firearms and other training weapons.  As a result, no live firearms or other weapons (e.g., knives) are permitted in rooms where non-live fire training classes or courses are being conducted, including “the Forge,” INPAX’s main physical training room.  Lockers or other secure facilities will be provided on site to secure firearms before entering the training area and INPAX requires that you deposit with INPAX your car keys and/or photo ID while your firearm is secured in a locker.   Strictly classroom-based classes or courses may be exempted from this rule.  Please direct any questions to INPAX staff.   
  12. Before engaging in any training class or course, you agree to (a) confirm, in consultation with your physician as appropriate, that you are physically capable of engaging in the training class or course, and (b) advise INPAX of any Limitations on your ability to participate in any training class or course, including any limitation that may arise after signing this Agreement but prior to attending or during the training class or course.  Please ask an INPAX representative for more details about the scope of and activities involved in any training class or course.
  13. Under no circumstances may you cross the firing line.  If you drop any equipment beyond the firing line, notify the Range Safety Officer immediately.
  14. INPAX may prohibit the use of any targets or the wearing of any apparel that it deems in its sole and absolute discretion to be offensive, unsafe, or distracting to a safe, family-friendly environment.
  15. No tobacco or other nicotine-containing product is permitted to be used at the Facility, and no food or drink are permitted on the Ranges.
  16. No person under the influence of alcohol or illegal drugs or under diminished capacity because of legal drugs is permitted entry to the Facility.
  17. No more than two individuals may be at a firing lane at any time.  Only one person at a time may handle, operate, or use a firearm at the firing lane.
  18. Any person under the age of 18 must be accompanied by a parent or legal guardian who has the legal authority to execute an Agreement on behalf of such minor.  No child under the age of 12 is permitted at the Facility absent the prior authorization of INPAX.  Please speak to the Range Safety Officer about such authorization.
  19. Any violation of these Rules, or any injury, damage to property, or accidental or negligent discharge of any firearm must be reported immediately to the Range Safety Officer.
  20. INPAX expects all users of the Facility to be familiar with the safe and proper handling and operation of their firearm.  If you have any questions, contact the Range Safety Officer, who will be happy to instruct you on the safe and proper handling of your firearm.
  21. Proper shooting attire is required to be worn at all times.  Ejected brass is hot, and will burn bare skin on contact.  Accordingly, INPAX does not recommend wearing open toed shoes or low cut or cropped shirts to the Facility.  Long hair should be tied back securely.  INPAX reserves the right to refuse entry to the firing lane area to any person wearing improper clothing, as determined by INPAX in its sole and absolute discretion.
  22. You must immediately comply with all commands and instructions issued by the Range Safety Officer.  If the Range Safety Officer issues a “CEASE FIRE” or “STOP” command, you must immediately STOP SHOOTING, and, keeping the firearm pointed towards the ground downrange, remove the magazine from the firearm, lock the slide back to the rear, and place your firearm on the bench with the muzzle pointing downrange.  Do not touch the firearm until cleared to do so by the Range Safety Officer.
    You must receive prior authorization from the Range Safety Officer before engaging in any shooting techniques beyond simple static shooting (for example, firing in connection with a draw stroke or firing from concealment).
  23. The discharge of all firearms must be controlled at all times, as determined in the sole and absolute discretion of the Range Safety Officer.
  24. INPAX reserves the right to refuse entry to or remove any person from the Facility if INPAX determines in its sole and absolute discretion that such person presents a danger to himself or others, is disrupting anyone at the Facility, or is otherwise engaging in unsafe or offensive conduct.
  25. All users of the INPAX indoor range must watch a safety video before entering the range for the first time.  By entering the range, you acknowledge and represent that you have viewed and understand the contents of the safety video.  Entry to the range without first viewing the safety video is grounds for removal from the Facility without refund. Please see INPAX staff for viewing details.

Never forget that YOU are a safety officer.   If you see an unsafe condition, you have the authority to immediately call a CEASEFIRE on the range, and alert INPAX Range Safety Officers to the problem.

VIOLATIONS OF RULES AND REGULATIONS

Any violation of any of the foregoing Rules is grounds for immediate removal from the Facility, without refund.  Depending on the severity of the violation, INPAX may in its sole and absolute discretion bar you from the Facility temporarily or permanently, including membership revocation, all without refund.

********** IMPORTANT LEGAL TERMS.  READ CAREFULLY. **********

ASSUMPTION OF RISK

READ THIS SECTION CAREFULLY.  In this section, you acknowledge that you fully understand the dangers and risks related to the use of firearms or being near the use of firearms.  You also assume all risks and dangers about which you are unaware.

You understand that the Facility is a shooting range where firearms will be discharged.  Inherent in the discharge of any firearm is exposure to loud noise, lead and other contaminants, hot brass, and the risk that you or another person may discharge a firearm in a manner that may result in you or your property being struck by a projectile that is likely to cause damage, serious injury, or death.  You are aware and understand that your and others’ use of firearms at the Facility is a dangerous activity and involves the risk of damage, serious injury, or death that cannot be eliminated because such risks are inherent in the handling and use of, or being in proximity to the handling and use of, firearms. You also acknowledge that there may be risks and dangers about which you are unaware, and you expressly assume all such risks and dangers unknown to you.

By willingly, knowingly and voluntarily signing this Agreement, entering the Facility and participating in activities, you hereby agree to accept and assume any and all risks of injury, death, or property damage, known or unknown, including those caused by the negligence or claimed negligence of INPAX, third parties, or otherwise.

RELEASE AND WAIVER OF CLAIMS AND COVENANT NOT TO SUE

READ THIS SECTION CAREFULLY.  In this section, you waive important rights you may have against INPAX, and you agree not to sue INPAX in connection with any damages, injury, or death you suffer, even if caused by the negligence of INPAX.

By willingly, knowingly and voluntarily signing this Agreement, you, on behalf of yourself and your family if you are alive, and on behalf of your heirs, assigns, and personal representative, if you are deceased, hereby waive, release, and discharge INPAX from and against any and all Claims of whatever kind, including attorney fees, now known or hereafter known, relating to any injury, death, or property damage incurred in connection with your entry to or presence at the Facility or your participation in any activity or training at the Facility, whether caused by the negligence of INPAX, any third parties, or otherwise. Further, on behalf of yourself and your family if you are alive, and on behalf of your heirs, assigns, and personal representative, if you are deceased, you covenant not to commence or institute any Claims of any kind whatsoever, in law or equity, or assert any Claim, demand, or cause of action against INPAX relating to your presence at or use of the Facility, any act or omission that occurs at, near, or in connection with the Facility, or any property damage, personal injury, or death you suffer at or in connection with the Facility. 

PHOTO AND VIDEO RELEASE

You understand that the Facility is under constant video and/or audiovisual surveillance.  You consent to such video and audiovisual surveillance and irrevocably give INPAX your consent to record you through audiovisual means and to photograph you, without any further consent required, for the purpose of ensuring Facility security and safety.  INPAX will maintain the confidentiality of any surveillance content created, and will only disclose or make available such content in connection with any law enforcement investigation, legally compelled disclosure, or to exercise its rights or meet its legal obligations in connection with its operation of the Facility.

INPAX may at times take photographs or video of training classes and courses it provides.  INPAX may take photographs or videos for advertising, marketing, or training purposes, mementos for participants, or for evaluations of instructors or participants.  Because it is very difficult to avoid including all class/course participants while taking photographs or video of the class or course, you are likely to be included in the photographs or videos taken.  By participating in any class or course that INPAX has advised will involve photography or video, you, on behalf of yourself and your family if you are alive, and on behalf of your heirs, assigns, and personal representative, if you are deceased, hereby consent to the use by INPAX of your image, likeness, and appearance in any manner or means whatsoever, whether now known or later developed, for any purpose set forth in this Agreement, without any right to prior review of any intermediary or final use of your image, likeness, or appearance.

By willingly, knowingly and voluntarily signing this Agreement, you waive and release INPAX from all Claims you may have arising directly or indirectly from the use by INPAX of your image, likeness, and appearance. You understand that this consent is irrevocable and does not entitle you to any payment or other consideration whatsoever. 

INDEMNIFICATION

READ THIS SECTION CAREFULLY.  In this section, you agree to be financially and legally responsible for any damages, injuries or death you cause or suffer.

By willingly, knowingly and voluntarily signing this Agreement, you, on behalf of yourself and your family if you are alive, and on behalf of your heirs, assigns, and personal representative, if you are deceased, shall defend, indemnify, and hold harmless INPAX against any and all Claims of whatever kind, including attorney fees, that you cause, incur, or suffer, even if caused, incurred, or suffered in connection with the negligence or claimed negligence of INPAX, in whole or in part. 

SPECIAL RELEASE FOR TRAINING ACTIVITIES

READ THIS SECTION CAREFULLY.  In this section, you agree to release INPAX from any injuries you may cause or suffer in connection with any training you receive from INPAX, even if caused by the negligence of INPAX.

INPAX offers training for all levels of skill and physical ability.  Basic or introductory training classes and courses have minimal physical contact and limited physical activity, while advanced force-on-force training involves a high degree of close physical contact and rapid physical movement, some of which are designed to provide a realistic approximation of combat and self-defense scenarios.  INPAX always takes reasonable precautions to avoid injury, but the very nature of physical training, including training classes and courses with little to no physical contact, may result in temporary or permanent injury.

Before registering for any training class or course, please speak to an INPAX representative about the scope of the training class or course you are considering.  INPAX relies on you to determine, with your physician as appropriate, whether you are physically fit and capable of engaging in the training class or course.  Prior to participating in any training class or course you must advise INPAX of any Limitations that may limit your participation in such training class or course, including those that arise after signing this Agreement but prior to or during your participation in the training class or course.

You recognize that training classes and courses involve strenuous physical activity and, depending on the class or course, may involve close physical contact with INPAX and third parties in simulated combat or self-defense scenarios.  You hereby affirm that you are in good physical condition and do not suffer from any known disability or condition which would prevent or limit your participation in the training class or course you are considering or for which you may register.  You fully understand that inherent in physical training is a risk of pain and injury, and the risk of pain or injury increases as the level of physical contact and exertion increases.  Pain and injuries could be permanent.

By willingly, knowingly and voluntarily signing this Agreement, you accept all risks associated with your participation in any training class or course, including risks about which you are currently unaware.  Further, in consideration of your participation in any training class or course, you, on behalf of yourself and your family if you are alive, and on behalf of your heirs, assigns, and personal representative, if you are deceased, hereby agree to defend, indemnify and hold INPAX harmless from all Claims of whatever kind that you incur in connection with your participation in any and all training classes and courses at any level, even if the negligence or claimed negligence of INPAX,, or any third party caused in whole or in part any harm or injury you suffer.

YOUR REPRESENTATIONS TO INPAX

By willingly, knowingly and voluntarily signing this Agreement, you represent and warrant to INPAX that (1) you are not prohibited from owning, purchasing, possessing, or using firearms under any federal, state, or local law, regulation, or rule; (2) you are not under the influence of any alcohol, illegal drug, legal drug that affects your judgment or ability to safely handle firearms or participate in training; (3), you are not suffering from any physical or mental condition that affects your ability to safely handle firearms or participate in training; and (4) you are over 18 years of age.  (5) You have no unlawful, illegal, wrongful or otherwise deceitful intentions in executing this Agreement, utilizing the range, or participating in training.

By willingly, knowingly and voluntarily signing this Agreement, you represent and warrant to INPAX that you understand that INPAX makes no warranty as to the design, function, maintenance, condition, safety, or fitness of the Facility for any particular purpose.  You agree that you accept the Facility “AS IS,” with all faults and defects.

By willingly, knowingly and voluntarily signing this Agreement, you represent and warrant to INPAX that you understand INPAX has no duty to render aid to you, but if it does, you consent to such aid (including providing or securing medical or first aid to you) and agree to hold INPAX harmless from any injury or death you suffer in connection with such aid, including injuries or death caused by the negligence or claimed negligence of INPAX in providing such aid.

GOVERNING LAW AND EXCLUSIVE JURISDICTION

All matters arising out of or relating to this Agreement shall be governed by and construed in accordance with the laws of the Commonwealth of Pennsylvania, without giving effect to its conflicts of law provisions.  Any claim or cause of action arising in connection with this Agreement or the Facility may be brought only in the federal and state courts located in Allegheny County, Pennsylvania.  You hereby irrevocably consent and submit to the exclusive jurisdiction of such courts, and agree not to argue for any reason that such courts are improper or inconvenient.

BINDING EFFECT

This Agreement and its assumption of risk, release and waiver of claims, covenant not to sue, and indemnification provisions are intended to be construed as broadly and as inclusively as permitted by law.  You acknowledge, intend, and agree that this Agreement legally binds not only you, but your family if you are alive, and your heirs, assigns, and personal representative, if you are deceased.  If any term or provision of this Agreement is invalid, illegal, or unenforceable in any jurisdiction, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this Agreement or invalidate or render unenforceable such term or provision in any other jurisdiction.

ENTIRE AGREEMENT

This Agreement constitutes the sole and entire agreement between INPAX and you with respect to the subject matter contained herein and supersedes all prior and contemporaneous understandings, agreements, representations, and warranties, both written and oral, with respect to such subject matter.

BY SIGNING BELOW, YOU ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD ALL THE TERMS OF THIS AGREEMENT AND THAT YOU ARE KNOWINGLY, WILLINGLY AND VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE INPAX.

Today's Date: December 11, 2018

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Emergency Contact

Name *

Relationship *

Phone *
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Emergency Contact

Name *

Relationship *

Phone *
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Emergency Contact

Name *

Relationship *

Phone *
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Emergency Contact

Name *

Relationship *

Phone *
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Emergency Contact

Name *

Relationship *

Phone *
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Emergency Contact

Name *

Relationship *

Phone *
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Emergency Contact

Name *

Relationship *

Phone *
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Emergency Contact

Name *

Relationship *

Phone *
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Emergency Contact

Name *

Relationship *

Phone *
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Emergency Contact

Name *

Relationship *

Phone *
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*
Check to receive information, news, and discounts by e-mail.
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
IF YOU ARE SIGNING THIS AGREEMENT ON BEHALF OF A MINOR, YOU ACKNOWLEDGE AND AGREE THAT YOU HAVE THE LEGAL RIGHT TO BIND SUCH MINOR TO THIS AGREEMENT, THAT ALL WAIVERS, RELEASES, AND INDEMNITIES CONTAINED IN THIS AGREEMENT BIND YOU AND THE MINOR WITH EQUAL FORCE, WAIVING AND RELEASING ANY CLAIMS THE MINOR MAY HAVE OR THAT YOU MAY HAVE BY OR THROUGH SUCH MINOR, AND THAT YOU AGREE TO DEFEND, INDEMNIFY, AND HOLD HARMLESS INPAX FROM AND AGAINST ANY CAUSE OF ACTION, CLAIM, COST LIABILITY, OR LOSS THAT INPAX INCURS IN CONNECTION WITH ANY CLAIM BROUGHT BY OR THROUGH THE MINOR FOR WHOM YOU ARE EXECUTING THIS RELEASE, INCLUDING FOR CLAIMS ARISING FROM THE NEGLIGENCE OR CLAIMED NEGLIGENCE OF INPAX.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Emergency Contact

Name *

Relationship *

Phone *
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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