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Black Axes
 

The individual named below (referred to as “I” or “me”) desires to participate in recreational axe throwing and axe throwing related activities (the “Activity”) provided by Black Axes Throwing Club, LLC, a Mississippi Limited Liability Company with its principal place of business in Rankin County, Mississippi (the “Company”).  As lawful consideration for being permitted by the Company to participate in the Activity, I agree to all terms and conditions set forth in this agreement (this “Agreement”).

I AM AWARE AND UNDERSTAND THAT THE ACIVITIES ARE DANGEROUS ACTIVITIES AND INVOLVE THE SIGNIFICANT RISK OF SERIOUS INJURY AND/OR PERMANENT PARALYSIS AND/OR DEATH AND/OR PROPERTY DAMAGE.  SUCH RISKS MAY BE FORSEEABLE OR UNFORSEEABLE, AND MAY INCLUDE, BUT ARE NOT LIMITED TO: FAILURE OF THE SAFETY BARRIERS, EQUIPMENT MALFUNCTION, MISS-THROWN AXES BY EMPLOYEES OR PARTICIPANTS, AND OTHER SUCH RISKS, HAZARDS AND DANGERS THAT ARE INTEGRAL TO RECREATIONAL ACTIVITIES THAT TAKE PLACE AT AN INDOOR RECREATIONAL AXE THROWING RANGE.  I REPRESENT THAT I AM IN GOOD HEALTH AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN THE ACTIVITIES.  I ACKNOWLEDGE  THAT ANY INJURIES THAT I SUSTAIN MAY BE COMPOUNDED BY NEGLIGENT EMERGENCY RESPONSE OR RESCUE OPERATIONS OF THE COMPANY.  I ACKNOWLEDGE THAT I AM VOLUNTARILY PARTICIPATING IN THE ACTIVITIES WITH KNOWLEDGE OF THE DANGER INVOLVED AND HEREBY AGREE TO ACCEPT AND ASSUME ANY AND ALL RISKS OF INJURY, DEATH, OR PROPERTY DAMAGE, WHETHER CAUSED BY THE NEGLIGENCE OF THE COMPANY OR OTHERWISE.

I hereby expressly waive and release any and all claims, no known or hereafter known, against the Company, and its officers, directors, employees, agents, affiliates, successors, and assigns (collectively, “Releases”), on account of injury, death or property damage arising out of or attributable to the Activities, whether arising out of the negligence of the Company or any Releases, and forever release and discharge the Company and all other Releases from liability under such claims. I further agree to obey all stated instructions, rules, and conditions during my participation in the Activities, and will remove myself from participation and contact a representative of the Company if I observe any unusual significant hazard related to the Activities.

I shall defend, indemnify, and hold harmless the Company and all other Releases against any and all losses, damages, liabilities, deficiencies, claims, actions, judgements, settlements, interests, awards, penalties, fines, costs or expenses of whatever kind, including attorney fees, fees and the costs of enforcing any right to indemnification under this Agreement, and the cost of pursuing any insurance providers, incurred by/awarded against the indemnified party arising out of or resulting from any claim of a third party related to my participation in the Activities.

This agreement constitutes the sole and entire agreement of the company and me 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.  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.  This Agreement is binding on and shall inure to the benefit of the Company and me and their respective successors and assigns.  All matters arising out of or relating to the Agreement shall be governed by and construed in accordance with the internal laws of the State of Mississippi without giving effect to any choice or conflict of law provision or rule (whether of the State of Mississippi or any other jurisdiction).  Any claim or cause of action arising under this Agreement may be brought only in the federal and state courts located in Rankin County, Mississippi and I hereby consent to the exclusive jurisdiction of such courts.

BY SIGNING, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD ALL OF THE TERMS OF THIS AGREEMENT AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INLCUDING THE RIGHT TO SUE THE COMPANY.

Today's Date: June 6, 2023

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

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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*

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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.


By signing below the parent or court-appointed legal guardian agrees that they are also 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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