Loading...

UNCONDITIONAL RELEASE AND WAIVER OF LIABILITY
(PLEASE READ CAREFULLY BEFORE SIGNING)

In Consideration of being allowed to enter Pikopye’s Town Central, a Dalemi Group Limited Liability Company, (“Pikopye’s Town”) and/or Pikopye's Town Lakeway, an Alki Enterprises LLC Company ("Pikopye's Town") and/or participate in any party and/or program at Pikopye’s Town, the undersigned, on his or her behalf, and on the behalf of the participant(s) acknowledges, and agrees to the following conditions: 

I fully understand and acknowledge that recreational activities have inherent risk, dangers, and hazards and such exists in my child's use of equipment, services, and activities (“Activities”) at Pikopye’s Town and I acknowledge I have visited the facility and investigated the Activities to my satisfaction. I execute this Release and Waiver of Liability with the intent to bind myself, my spouse (if applicable), my heirs, assigns, and legal representatives. I further state that I am at least 18 years of age or older and competent to sign this affirmation and Release.


 

I fully understand and agree that certain elements of the Activities of Pikopye’s Town may be physically and emotionally demanding and that by my child's participation here, he/she faces risks of physical injury. These risks may include but are not limited to: (1) loss or damage to personal property; (2) injury or fatality due to and/or related to (a) walking, running, jumping, playing, and/or falling, (b) fighting with, being hit by, and/or hitting any of the Pikopye’s Town participants, or any other person, and (c) slips and falls.


 

I understand and assume the risks for myself and my child’s participation at Pikopye’s Town. I further represent that my child is in good physical condition, and does not possess, nor am I aware of, any physical or mental disabilities which will limit my child’s participation at Pikopye’s Town.


 

I EXPRESSLY AGREE AND INTEND THAT BOTH MY AND MY CHILD’S PARTICIPATION AT PIKOPYE’S TOWN SHALL BE UNDERTAKEN AT OUR OWN RISK AND THAT PIKOPYE’S TOWN SHALL NOT BE LIABLE FOR ANY INJURIES, DAMAGES, CLAIMS, DEMANDS, ACTIONS, OR CAUSES OF ACTION WHATSOEVER WHICH MAY ARISE OUT OF OR IN CONNECTION WITH ME OR MY CHILD’S PARTICIPATION IN PIKOPYE’S TOWN, AND I DO HEREBY FOREVER RELEASE, DISCHARGE, INDEMNIFY, HOLD HARMLESS AND WILL DEFEND PIKOPYE’S TOWN FROM ANY SUCH INJURIES, DAMAGES, CLAIMS, DEMANDS, ACTIONS OR CAUSES OF ACTION, AND COSTS, INCLUDING ATTORNEY’S FEES.

The terms of this Release and Waiver of Liability are to be governed by and construed under the laws of the state of Texas. In the event any term or provision of this Release and Waiver of Liability is found to be unenforceable or void, in whole or in part, the term or provision concerned shall be construed as valid and enforceable to the maximum extent permitted by law, and the balance of this Release and Waiver of Liability shall remain in full force and effect. 

Dated: November 22, 2024

First Participant's Name

First Name*

Last Name*
First Participant's Age Acknowledgment*
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

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*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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*

Phone*
Parent or Guardian's Age Acknowledgment*
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!