Loading...

DBA: CITY OF FIRSTS ADVENTURE PARK
Release of Liability, Assumption of Risk, Indemnification and Waiver Agreement 

 

 

I, as the signer (hereon described as the 'signer') for self, as parent/guardian, or for any minor child I am taking the liberty to sign for, my heirs, executors, administrators and assigns, do release, waive, discharge and covenant not to sue KOKOMO RACEWAY II LLC/DRG REAL ESTATE LLC, DBA: CITY OF FIRSTS ADVENTURE PARK (hereon described as ‘above entities’), its owners, managers/members, contractors, agents and employees (hereon described and included as 'above entities') and agree to hold it harmless from all liability for its or your negligent acts or omissions resulting from any participation in any and all park activities including and not limited to the indoor facility, go-kart track/activities, batting cages, miniature golf courses, parking lot and all other facility property, known or anticipated, that result in physical or emotional injury, infection or illness by personal or secondary exposure, paralysis, death or damage to myself, to my minor child (or the minor child I'm taking liberty to sign for), or to our property. I understand that all children under the age of 16 years old require parental/adult guardian supervision at all times while visiting above facility/grounds and agree to this under all circumstances and requirements. * I understand that my signature as 'signer' makes me completely responsible for all included paragraphs, parts and pieces in this waiver forever and into the future, and that if I choose to override park regulations and rules by acting upon my own wishes or that of my minor child (or minor child that I am taking the liberty to sign for), that I am completely responsible for any negligence as the 'signer'. (example: placing my child in a go-kart when they do not meet height/age/size regulations; choosing not to place helmet on child or self when recommended for go-karts or batting cages, leaving minor's unattended).

I acknowledge as 'signer' that the activities and services offered by ‘above entities’ may be inherently dangerous and may cause injury or damage. I agree to and understand all verbal, written, signage and otherwise assumed instructions and rules both provided and specified by my presence at this establishment. I am assuming as 'signer' all risk of personal injury, death or disability which may result from participation or use of ‘above entities’ facilities or activities. This Release, Assumption of Risk, Indemnification, and Waiver specifically extends to the use of all equipment and activities as well as the premises of ‘above entities’ and includes any claim for strict liability arising out of the use of all equipment, activities and premises. I certify that I as 'signer' I have adequate health insurance to cover any injury or damage caused to me as 'signer' or those I sign for, OR else I agree to personally bear the cost of such injury or damage. I understand that as 'signer' just because my child or any child I am taking liberty to sign for or bring to this facility is old enough or of acceptable size to participate in any activity that they may not be emotionally, physically or mentally capable or mature enough and this is my decision and assessment to make and not that of the owners, management or staff. If I as 'signer' unknowingly or knowingly place my own child or any child I bring to this facility or property in danger or harm's way I agree that I am responsible for that child's safety as well as any negligence or injury he/she may suffer whether I sign a waiver for that child or neglect to sign a waiver as a result of my own decision not to do so or oversight by owners, managers or staff.

I agree that as 'signer' this Agreement extends forever into the future and covers any visit for which this Release, Assumption of Risk, Indemnification, and Waiver applies as well as any return or repeat visits by either myself as 'signer' or those I have signed for in the future. I agree to defend, indemnify and hold ‘above entities’ harmless from any and all losses, liabilities, claims, damages or other financial harm incurred by ‘above entities’, including reasonable attorneys’ fees, as a result of any actions of myself or as 'signer' as well as any injury or damage caused to any other person during my participation and activities at ‘above entities’ premises. 

I as 'signer' hereby authorize and consent to the use of my voice, photograph and likeness as well as that of any minor child covered by this Agreement by ‘above entities’ without reservation or limitations. I agree to receive no compensation for this use, and property rights to any photographs or video material produced or prepared by ‘above entities’ shall vest in and remain with above facility/premise. The waiver and release included in this Agreement shall extend to the use of voice, photograph or likeness covered by this paragraph. 

I as 'signer' understand that by executing this Agreement I am giving up any right to bring legal action or assertion of a claim against Kokomo Raceway II LLC/DRG Real Estate LLC/ DBA: City of First Adventure Park for (its) or any owner, manager, employee, member, contractor, agent, or another customer’s negligence or for any defective product, equipment, activity, facility or property on its premises, including any property or equipment of my own that I bring to above listed and included facilities/properties. This Release, Assumption of Risk, Indemnification, and Waiver Agreement shall be construed under the laws of the state of Indiana. 

                                                                 Today's Date: August 10, 2022_________________________________________

*ONE WAIVER PER PARTICIPANT IS REQUIRED. MINORS (known and included as my minor child or minor that I take the liberty of signing a waiver for) MUST HAVE SEPARATE WAIVER WITH PARENT/LEGAL GUARDIAN’S SIGNATURE. ** Please understand that this is necessary by agreement with liability insurance company request & requirement!





Please select who will be participating...
AdultMinor
Continue
First Participant/s Name

First Name*

Last Name*

Phone*
First Participant/s Date of Birth*
First Participant/s Signature*
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*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
* This part only needs to be completed if you are planning to drive a FAST go-kart now or in the future! Do not complete for children or if you are driving only a concession kart!

Current height

Current weight

Current Age:

Current experience in go-kart RACING:
Do you have a current and valid driver's license?
no
if no, could you provide a valid form of picture identification?
yes
Do you agree that this waiver covers (Kokomo Raceway II LLC DBA: City of Firsts Adventure Park & DRG Real Estate LLC) ALL activities, ALL special racing events on any date including today's date & future dates and that I may be asked to complete a new waiver at each event? If No is selected you will not be allowed to participate in this or future events.
no
yes
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*

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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!