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The Circle VR LLC - Release of Liability Waiver

WAIVER AND RELEASE OF LIABILITY: In consideration of the risk of injury while participating in Virtual reality (the "Activity"), and as consideration for the right to participate in the Activity, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this waiver and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in the Activity, and do hereby release and forever discharge The Circle VR, LLC, located at 5880 Fulton Dr NW, Canton, Ohio, 44718 their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economical or emotional loss, that I may suffer as a direct result of my participation in the aforementioned Activity, including traveling to and from an event related to this Activity.

I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH TRAVELING TO AND FROM AS WELL AS PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, INFECTIOUS DISEASE, DISFIGUREMENT, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS' NEGLIGENCE, CONDITIONS RELATED TO TRAVEL, OR THE CONDITION OF THE ACTIVITY LOCATION(S). NONETHELESS, I ASSUME ALL RELATED RISKS, BOTH KNOWN OR UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY, INCLUDING TRAVEL TO, FROM AND DURING THIS ACTIVITY.

I agree to indemnify and hold harmless The Circle VR, LLC against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney's fees and any related costs, if litigation arises pursuant to any claims made by me or by anyone else acting on my behalf. If The Circle VR, LLC incurs any of these types of expenses, I agree to reimburse The Circle VR, LLC. I acknowledge that The Circle VR, LLC and their directors, officers, volunteers, representatives and agents are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of The Circle VR, LLC.

I ACKNOWLEDGE THAT THIS ACTIVITY MAY INVOLVE A TEST OF A PERSON'S PHYSICAL AND MENTAL LIMITS AND MAY CARRY WITH IT THE POTENTIAL FOR DEATH, SERIOUS INJURY, AND PROPERTY LOSS. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, lack of hydration, condition of participants, equipment, rogue alligators, ghosts, extra terrestrials, vehicular traffic and actions of others, including but not limited to, participants, volunteers, spectators, coaches, event officials and event monitors, and/or producers of the event.

I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS "WAIVER AND RELEASE" AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE THE CIRCLE VR, LLC AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST The Circle VR, LLC FOR PERSONAL INJURY OR PROPERTY DAMAGE. To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence on the part of The Circle VR, LLC, its

agents, and employees. In the event that I should require medical care or treatment, I agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance. In the event that any damage to equipment or facilities occurs as a result of my or my family's willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any actions of neglect or recklessness.

This Agreement was entered into at arm's-length, without duress or coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both the Participant, (signed below) and The Circle VR, LLC agree that this Agreement is clear and unambiguous as to its terms, and that no other evidence will be used or admitted to alter or explain the terms of this Agreement, but that it will be interpreted based on the language in accordance with the purposes for which it is entered into. In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the clause severed does not affect the intent of the parties. If a court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited. I, the undersigned participant, affirm that I am of the age of 18 years or older, and that I am freely signing this agreement. I certify that I have read this agreement, that I fully understand its content and that this release cannot be modified orally. I am aware that this is a release of liability and a contract and that I am signing it of my own free will.

I will NOT use the Virtual Reality equipment:

  1. If I have any communicable or infectious desease or illness, skin disorder, largecuts, open sores, or wounds;
  2. If I am under the influence of alcohol or drugs;
  3. If I am epileptic, unless in my opinion of my physician, my epilepsy is under medical control so that I am in sufficient control of my seizures not to endanger myself.

I understand that any items I bring to The Circle VR LLC, including, but not limited to: camera, MP3 player, cell phone, other personal electronics, jewelry, glasses, etc., are the responsibility of myself, and The Circle VR LLC is in no way responsible for lost, missing, stolen, or damaged items.

I certify that I have read this agreement, that I fully understand its content and that this release cannot be modified orally. I am aware that this is a release of liability and a contract and that I am signing it of my own free will.

By checking the box next to I AGREE below, 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 which is available at our location. By hitting accept, 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.

 

I Agree

Today's Date: August 10, 2020

 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Media Release
Media Release * By selecting "Yes!" below you are consenting for yourself and for any minors listed on this form to use by The Circle VR, LLC of any images, videos, and testimonies for copy, edit, reproduction and use in any way they see fit, including but not limited to advertising, media, and promotion.*
No, I do not want photos or videos of the participant(s).
Yes! I will allow The Circle VR to take and possibly share publicly photos and/or videos of the participant(s)
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Media Release
Media Release * By selecting "Yes!" below you are consenting for yourself and for any minors listed on this form to use by The Circle VR, LLC of any images, videos, and testimonies for copy, edit, reproduction and use in any way they see fit, including but not limited to advertising, media, and promotion.*
No, I do not want photos or videos of the participant(s).
Yes! I will allow The Circle VR to take and possibly share publicly photos and/or videos of the participant(s)
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Media Release
Media Release * By selecting "Yes!" below you are consenting for yourself and for any minors listed on this form to use by The Circle VR, LLC of any images, videos, and testimonies for copy, edit, reproduction and use in any way they see fit, including but not limited to advertising, media, and promotion.*
No, I do not want photos or videos of the participant(s).
Yes! I will allow The Circle VR to take and possibly share publicly photos and/or videos of the participant(s)
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Media Release
Media Release * By selecting "Yes!" below you are consenting for yourself and for any minors listed on this form to use by The Circle VR, LLC of any images, videos, and testimonies for copy, edit, reproduction and use in any way they see fit, including but not limited to advertising, media, and promotion.*
No, I do not want photos or videos of the participant(s).
Yes! I will allow The Circle VR to take and possibly share publicly photos and/or videos of the participant(s)
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Media Release
Media Release * By selecting "Yes!" below you are consenting for yourself and for any minors listed on this form to use by The Circle VR, LLC of any images, videos, and testimonies for copy, edit, reproduction and use in any way they see fit, including but not limited to advertising, media, and promotion.*
No, I do not want photos or videos of the participant(s).
Yes! I will allow The Circle VR to take and possibly share publicly photos and/or videos of the participant(s)
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Media Release
Media Release * By selecting "Yes!" below you are consenting for yourself and for any minors listed on this form to use by The Circle VR, LLC of any images, videos, and testimonies for copy, edit, reproduction and use in any way they see fit, including but not limited to advertising, media, and promotion.*
No, I do not want photos or videos of the participant(s).
Yes! I will allow The Circle VR to take and possibly share publicly photos and/or videos of the participant(s)
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Media Release
Media Release * By selecting "Yes!" below you are consenting for yourself and for any minors listed on this form to use by The Circle VR, LLC of any images, videos, and testimonies for copy, edit, reproduction and use in any way they see fit, including but not limited to advertising, media, and promotion.*
No, I do not want photos or videos of the participant(s).
Yes! I will allow The Circle VR to take and possibly share publicly photos and/or videos of the participant(s)
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Media Release
Media Release * By selecting "Yes!" below you are consenting for yourself and for any minors listed on this form to use by The Circle VR, LLC of any images, videos, and testimonies for copy, edit, reproduction and use in any way they see fit, including but not limited to advertising, media, and promotion.*
No, I do not want photos or videos of the participant(s).
Yes! I will allow The Circle VR to take and possibly share publicly photos and/or videos of the participant(s)
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Media Release
Media Release * By selecting "Yes!" below you are consenting for yourself and for any minors listed on this form to use by The Circle VR, LLC of any images, videos, and testimonies for copy, edit, reproduction and use in any way they see fit, including but not limited to advertising, media, and promotion.*
No, I do not want photos or videos of the participant(s).
Yes! I will allow The Circle VR to take and possibly share publicly photos and/or videos of the participant(s)
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Media Release
Media Release * By selecting "Yes!" below you are consenting for yourself and for any minors listed on this form to use by The Circle VR, LLC of any images, videos, and testimonies for copy, edit, reproduction and use in any way they see fit, including but not limited to advertising, media, and promotion.*
No, I do not want photos or videos of the participant(s).
Yes! I will allow The Circle VR to take and possibly share publicly photos and/or videos of the participant(s)
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
How did you discover The Circle VR?

If other, how did you find us?
Any special occasion?
No
Birthday
Date Night
Anniversary
Other

If Other, let us know!
Have you tried Virtual Reality before?
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*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Media Release
Media Release * By selecting "Yes!" below you are consenting for yourself and for any minors listed on this form to use by The Circle VR, LLC of any images, videos, and testimonies for copy, edit, reproduction and use in any way they see fit, including but not limited to advertising, media, and promotion.*
No, I do not want photos or videos of the participant(s).
Yes! I will allow The Circle VR to take and possibly share publicly photos and/or videos of the participant(s)
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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