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DYNO-ROCK, INC. RELEASE AND PARENT/GUARDIAN WAIVER OF LIABILITY AND ASSUMPTION OF RISK

PLEASE READ THIS DOCUMENT CAREFULLY. BY SIGNING IT, YOU ARE GIVING UP LEGAL RIGHTS

I, the undersigned on my behalf and, if applicable, my child/ward named below (hereinafter “RELEASOR”) hereby acknowledge that I and my child/ward desire to voluntarily participate in the activities and services provided by Dyno-Rock, Inc. and its affiliates, instructors, instructors, officers, directors, agents, employees, designers, licensors, and members, as well as the property owner and tenants of the property, and the owners, manufacturers, and installers of the equipment comprising the Dyno-Rock facility (collectively, “DYNO-ROCK” or “RELEASEES”), including but not limited to, the use of the equipment, facilities, walls, ropes, pads, instruction, training, exercises, strenuous bodily movement, and premises (collectively, the “DYNO- ROCK ACTIVITIES”), and further agree and acknowledge as follows:

ASSUMPTION OF RISK: I understand and acknowledge that the Dyno-Rock Activities have varying effects on individuals based upon their size, age, physical condition and/or state of health. I further understand and agree that it is my sole decision whether to consult with a medical professional prior to participating in the Dyno-Rock Activities, and that DYNO-ROCK recommends that participants consult with a medical professional prior to participating in the DYNO-ROCK ACTIVITIES, especially if I or my child/ward has a recent injury, surgery, pregnancy or other health condition. I, and/or my child/ward, have either consulted a physician and received medical advice and consent to participation in DYNO-ROCK ACTIVITIES or have waived such advice and consent of a physician and accept any and all RISKS. I am assuming, on behalf of myself and/or my child/ward, all risks of personal injury, death, or disability to myself and/or my child/ward that may result from participation in the DYNO-ROCK ACTIVITIES, or any damage, loss or theft of any personal property which me and/or my child/ward may occur at the DYNO-ROCK ACTIVITIES.

I am aware of, and understand and acknowledge that participation in the DYNO-ROCK ACTIVITIES is a potentially hazardous activity and involves inherent risks of danger or injury, including, but not limited to, sprains, strains, fractures, concussions, contusions, lacerations, abnormal blood pressure, heart disorders, fainting, shortness of breath, chest pains, strokes, heart attack or event death (collectively referred to as “RISKS”). I, or my child/ward, is voluntarily participating in the DYNO-ROCK ACTIVITIES with knowledge of the RISKS and danger involved, and with the knowledge that staff assistance and/or medical facilities may not be available or adequate in the event of injury or illness. I HEREBY AGREE TO ACCEPT ANY AND ALL RISK (AS DESCRIBED HEREIN) OF INJURY, ILLNESS, OR DEATH INHERENT IN OR ARISING FROM THE DYNO-ROCK ACTIVITIES AND VERIFY THIS STATEMENT BY PLACING MY SIGNATURE BELOW.

RELEASE OF LIABILITY: I understand that myself, and/or my child/ward, will be engaging in DYNO-ROCK ACTIVITIES using the DYNO-ROCK facility and it is my voluntary and informed decision to release any future lawsuits or claims that I and/or they have or may have against RELEASEES. RELEASOR expressly releases and forever discharges and holds harmless RELEASEES from any and all liability, claims, demands or causes of action whatsoever arising out of any damage, loss, personal injury, or death to me or my child/ward, while participating in the DYNO-ROCK ACTIVITIES. This release is valid and effective whether the damage, loss, or death is a result of any act or omission on the part of any RELEASEES or from any other cause. This Waiver and Release of Liability includes, but is not limited to, injuries, or accidents, which may occur as a result of the: (a) use or misuse of the facility in any way by anyone; (b) use of any equipment that malfunctions or breaks; (c) improper maintenance of the facility, grounds, or any equipment; (d) instruction or supervision; or (e) slipping, tripping and /or falling while in the facility or on the surrounding premises.

As consideration for being permitted by DYNO-ROCK to participate in DYNO-ROCK ACTIVITIES, I hereby agree that I, my assignees, heirs, distributes, guardians, and any other legal representative of mine will not make a claim against, or sue, DYNO-ROCK, INC. or its past, present or future parent, subsidiaries, affiliates, related entities, successors, owners, members, directors, officers, shareholders, agents, employees, servants, assigns, investors, legal representatives or any individuals or entities involved in the operations of DYNO-ROCK for injury, illness, death, or damage resulting from any participation in DYNO- ROCK and the RISKS involved therein.

I further grant DYNO-ROCK the right to photograph, videotape, and/or record me and/or my child/ward and to use my or my child/ward’s name, face, likeness, voice and appearance in connection with exhibitions, publicity, advertising, and promotional materials without reservation or limitation. I further consent to receive email, SMS messages, and other electronic of telephonic communications regarding DYNO-ROCK events, activities, products, advertisements and offerings.

I, HEREBY ASSUME ALL RISK AND RULLY RELEASE, ACQUIT, WAIVE, COVENANT NOT TO SUE AND FOREVER DISCHARGE DYNO-ROCK, INC., ITS PAST, PRESENT OR FUTURE PARENT, SUBSIDIARIES, AFFILIATES, RELATED ENTITIES, SUCCESSORS, OWNERS, MEMBERS, DIRECTORS, OFFICERS, SHAREHOLDERS, AGENTS, EMPLOYEES, SERVANTS, ASSIGNS, INVESTORS, LEGAL REPRESENTATIVES OR ANY INDIVIDUALS OR ENTITIES INVOLVED IN THE OPERATIONS OF DYNO-ROCK, OF AND FROM ANY AND ALL PAST, PRESENT AND FUTURE CLAIMS ARISNG FROM THEIR ACTS AND/OR OMISSIONS, INCLUDING BUT NOT LIMITED TO, DEMANDS, OBLIGATIONS, ATIONS, CAUSES OF ACTION, RIGHTS, DAMAGES, COSTS, NEGLIGENCE CLAIMS, GROSS NEGLIGENCE CLAIMS, ASSAULT CLAIMS, INTENTIONAL INFLICTION OF EMOTIONAL DISTRESS CLAIMS, PERSONAL INJURY CLAIMS, PREMISES LIABILITY CLAIMS, PRINCIPAL-AGENT CLAIMS, MENTAL ANGUISH CLAIMS, PAIN AND SUFFERING CLAIMS, PHYSICAL IMPAIRMENT CLAIMS, DISFIGUREMENT CLAIMS, LOST WAGES CLAIMS, LOSS OF EARNING CAPAITY CLAISM, WARRANTY CLAIMS, PUNITIVE DAMAGES CLAIMS, EXEMPLARY DAMAGES CLAIMS, AND ANY OTHER FORM OF COMPENSATORY CLAIMS OF ANY NATURE WHATSOEVER, WHETHER BASED ON A TORT, CONTRACT, OR OTHER THEORY OF RECOVERY, WHETHER SAME BE KNOWN OR REALIZED OR UNKNOWN AND NOT REALIZED, THAT I, MY ASSIGNEES, HEIRS, DISTRIBUTEES, GUARDIANS OR LEGAL REPRESENTATIVES NOW HAVE, HAVE HAD OR EVER WILL HAVE FOR INJURY, ILLNESS, DEATH OR DAMAGE RESULTING FROM MY PARTICIPATION IN DYNO-ROCK ACTIVITIES AND ANY RISKS INVOLVED WITH OR ARISING OUT OF SAME. THIS RELEASE IS INTENDED BY BOTH PARTIES TO BE AS BROAD IN ITS EFFECT AS ALLOWED BY LAW.

I HAVE CAREFULLY READ THIS WAIVER OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT IN ITS ENTIRETY AND FULY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A WAIVER, RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT AND A LEGAL CONTRACT BETWEEN ME AND DYNO- ROCK, INC. AND THAT IT AFFECTS MY LEGAL RIGHTS. I AM SIGNING THIS DOCUMENT OF MY OWN FREE WILL. A COPY OF THIS DOCUMENT, DIGITAL, ELECTRONIC OR OTHERWISE IS AUTHENTIC AND EFFECTIVE AS THE ORIGINAL.

Today's Date: July 4, 2020

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
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

First Name*

Last Name*
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*
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*
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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*

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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