Release of Liability, Assumption of Risk, Indemnification and Waiver Agreement 


I (PARTICIPANT or PARENT/LEGAL GUARDIAN), on behalf of myself or my minor child, my heirs, executors, administrators and assigns, 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 and agree to hold it harmless from all liability for its negligent acts or omissions resulting from any participation in any and all park activities including and not limited to the arcade/indoor facility, go-kart track/activities, batting cages, miniature golf courses, and all other facility property, known or anticipated, that result in physical or emotional injury, paralysis, death or damage to myself, to my minor child, or to our property. 

I acknowledge on behalf of myself or my minor child that the activities and services offered by ‘above entities’ may be inherently dangerous and may cause injury or damage. I am assuming on behalf of myself or my minor child 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 have adequate health insurance to cover any injury or damage caused to me or my minor children, OR else I agree to personally bear the cost of such injury or damage. 

I agree that 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 or my minor child 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 my minor child/children as well as any injury or damage caused to any other person during my participation and activities at ‘above entities’ premises. 

I 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 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. This Release, Assumption of Risk, Indemnification, and Waiver Agreement shall be construed under the laws of the state of Indiana. 

Today's Date: September 20, 2019


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First Participant's Name

First Name*

Last Name*

First Participant's Date of Birth*
First Participant's Signature*
Participant's Address
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Address Line 2:
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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*
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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