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 Rage Room Orlando (Coping Lab LLC) Participant Agreement

Assumption of Risk, and Waiver of Liability Please read this document carefully before signing as it has legal consequences and will affect your legal rights.This Agreement, Assumption of Risk, and Waiver of Liability is by the undersigned person in favor of Coping Lab LLC and all Coping Lab, LLC’s members, managers, officers, employees, agents, volunteers, contractors, insurers, affiliated entities, and assigns (collectively “Coping Lab LLC ”). You have the right to refuse to sign this Agreement, Assumption of Risk, and Waiver of Liability and forego participation in Rage Room.

Assumption of Inherent Risks (Please initial after reading, understanding, and accepting the following)

In consideration of the venue, equipment, and services provided by Coping Lab LLC and my desire to participate in the activities offered at Coping Lab LLC today and in the future, I acknowledge, accept, and agree as follows:

Activities inCoping Lab LLC are inherently risky. Such risks include (but are not limited to) flying and floor debris, slipping and tripping hazards, confined spaces, collisions, surprises, impacts, sharp and jagged edges, shocks, stress, rebounds, vibrations, acts and omissions by other people, changing environmental conditions, equipment failure, physical exertion, unusual physical stresses, loud noises, and other risks not specifically named. For myself and for my minor child (if applicable), I freely accept and fully assume all such risks.

Coping Lab LLC offers strenuous activities that include known and unanticipated risks. Participation is voluntary. Participation can result in injury. For myself and for my minor child (if applicable), I freely accept and fully assume all such risks.

For myself and for my minor child (if applicable), I agree to use Coping Lab’s venue, equipment, and services reasonably, responsibly, and safely. For myself and for my minor child (if applicable), I agree to participate within my physical ability.

For myself and for my minor child (if applicable), I agree to abide by all Coping Lab’s rules as related by Coping Lab’s employees and signage. For myself and for my minor child (if applicable), I agree to follow all directions given by Coping Lab’s employees.

For myself and for my minor child (if applicable), I agree to use available protective clothing and equipment while participating in the activities offered by Coping Lab including facial visor use at all times.

Activities in Coping Lab LLC may cause significant physical, mental, and emotional stresses. Coping Lab LLC recommends consultation with a qualified physician prior to Coping Lab LLC activities.

Coping Lab LLC recommends that pregnant women should not participate in the activities offered at Coping Lab LLC .

Coping Lab LLC recommends that people with medical conditions that can be triggered and/or exacerbated should not participate in the activities offered at Coping Lab LLC , specifically including (but not limited to) those with asthma; epilepsy; a cardiorespiratory issue; hypertension; mental illness; a muscle, skeletal, or joint issue; an open or recent wound; and others not specifically named.

People who have been advised or cautioned against the activities offered at Coping Lab LLC are prohibited from participating. • Intoxicated people are prohibited from participating in the activities offered by Coping Lab LLC

For myself and for my minor child (if applicable), I confirm that I have inspected the venue, equipment, and services provided by Coping Lab LLC and, based upon that inspection, found it to be PD.24433469.1 safe and acceptable for participation. I agree to immediately notify a Coping Lab LLC employee if I become aware of a condition that is or may become not safe and acceptable for participation.

Waiver of Liability (Please initial after reading, understanding, and accepting the following)

IN CONSIDERATION OF THE VENUE, EQUIPMENT, AND SERVICES PROVIDED BY Coping Lab LLC , AND MY DESIRE TO PARTICIPATE IN THE ACTIVITIES OFFERED AT Coping Lab LLC TODAY AND IN THE FUTURE, FOR MYSELF AND FOR MY MINOR CHILD (IF APPLICABLE), I AGREE TO WAIVE, RELEASE, AND DISCHARGE Coping Lab LLC FROM ANY AND ALL CLAIMS RESULTING FROM ACTIVITIES AND/OR PARTICIPATION IN Coping Lab LLC INCLUDING ANY AND ALL CLAIMS CAUSED BY OR RELATED TO THE VENUE, EQUIPMENT, AND SERVICES PROVIDED BY Coping Lab LLC . THIS AGREEMENT APPLIES TO CLAIMS OF PERSONAL INJURY (INCLUDING DEATH), ILLNESS, PROPERTY DAMAGE, AND LOSS OR THEFT OF PROPERTY.

Indemnification Agreement (Please initial after reading, understanding, and accepting the following)

In consideration of the venue, equipment, and services provided by Coping Lab LLC, and my desire to participate in the activities offered at Coping Lab LLC today and in the future, for myself and for my minor child (if applicable), I agree to hold harmless, defend, and indemnify Coping Lab LLC from any and all claims arising from activities and/or participation in Coping Lab LLC including all such claims made by me, my minor child (if applicable), other participants, rescuers, and any other person. 

Minor Child Participation (If applicable, please initial after reading, understanding, and accepting the following)

By signing this Agreement, Assumption of Risk, and Waiver of Liability, you are agreeing to let your minor child engage in a potentially dangerous activity that can result in injury, you are giving up your child's right and your right to assert a claim against Coping Lab LLC resulting from activities and/or participation in Coping Lab LLC including any and all claims caused by or related to the venue, equipment, and services provided by Coping Lab LLC . You have the right to refuse to sign this Agreement, Assumption of Risk, and Waiver of Liability and forego your child’s participation in Coping Lab LLC.

Other Agreements (Please initial after reading, understanding, and accepting the following)

For myself and for my minor child (if applicable), I consent to recording by video, photograph, and audio

during Coping Lab LLC activities and use of all such video, photographic, and audio recordings by Coping Lab LLC including publication upon its social media platforms.The appropriate venue for any legal action relative to any claims arising from activities and/or participation in Coping Lab LLC and/or this Agreement, Assumption of Risk, and Waiver of Liability is Pinellas County, Florida.

The person signing this Agreement, Assumption of Risk, and Waiver of Liability must be 18 years or older.

Today's Date: October 27, 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*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Read this form completely and carefully. By signing the attached Agreement, Assumption of Risk, and Waiver of Liability, you are agreeing to let your minor child engage in a potentially dangerous activity that can result in injury, you are giving up your child's right and your right to assert a claim against Coping Lab LLC resulting from activities and/or participation in Coping Lab LLC including any and all claims caused by or related to the venue, equipment, and services provided by Coping Lab LLC.
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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