Loading...

General Waiver for All Participates in Physical Activity at TBK Bank Sports Complex, including an Assumption of Risk and Waiver of Liability Relating to Coronavirus/COVID-19

General Participation Waiver:

This Waiver and Release Form is made as of the date written below by the individual(s) signing this form ("Participant") and provided to The BettPlex, LLC, a Minnesota limited liability company ("BettPlex"). The entire sports complex is owned by BettPlex and is known as TBK Bank Sports Complex (the "Facilities"). BettPlex also owns the fitness center which operates under the name of Level II Fitness and the family entertainment center which operates under the name of High 5 Lanes & Games

I hereby assume all of the risks of participating in all activities at any of these facilities, including by way of example but not limited to any risks that may arise from: negligence or carelessness on the part of the persons or entities beign released, dangerous or defective equipment or property owned, maintained or controlled by them, or their possible liability without fault. I certify that I am physically fit, have sufficiently prepared or trained for participation in this activity and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which could affect my participation in this activity. 

I acknowledge that this Waiver and Release of Liability will be used by the event holders, sponsors and organizers of the activity in which I may participate and that it will govern my actions and responsibilities at said activity. In consideration of my use of facilities or services provided at TBK BANK SPORTS COMPLEX, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors and assigns as follows:

A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: The BettPlex, LLC (known as TBK BANK SPORTS COMPLEX and including HIGH 5 LANES & GAMES) and its directors, officers, employees, volunteers, representatives, agents, activity holders, and sponsors;

B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in the above paragraph from any and all liabilities or claims made as a result of my use of these facilities, whether caused by the negligence of the Releasees or otherwise. 

I acknowledge the TBK BANK SPORTS COMPLEX and its members, managers, employees, agents and contractors ("Releasees") are NOT responsible for the errors, omissions, acts or failures to act of any person or entity conducting a specific activity. 

I acknowledge that this activity may involve a test of physical and mental limits and carries with it the potential for death, serious injury and property loss. The risks include, but are not limited to, those caused by facilities, temperature, weather, condition of participants, equipment, lack of hydration and actions of other people including, but not limited ot, participants, volunteers, coaches, parents, officials, umpires, referees, monitors, spectators and sponsors of any activity. These risks are not only inherent to participants, but are also present for volunteers and parents. 

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident and/or illness during this activity.

I understand while participating in this activity, I may be photographed. I agree to allow my photo or video of my likeness to be used for any legitimate purpose by TBK Bank Sports Complex and its employees, agents and assigns.

Check this box to accept:

I Agree

Date: June 28, 2022

COVID-19 Waiver:

The novel coronavirus ("COVID-19") has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have in many locatins, prohibited the congregation of groups of people. The BettPlex LLC (known as the TBK Bank Sports Complex and including High 5 Lanes & Games and Level II Fitness) has put in place preventative measures to reduce the spread of COVID-19; however, cannot guarantee that you will not become infected with COVID-19. Further, attending any program or activity at the BettPlex could increase your risk of contracting COVID-19. 

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily asume the risk that I may be exposed to or infected by COVID-19 while attending The BettPlex, and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at TBK Bank Sports Complex may result from the actions, omissions, or negligence of myself and others, including, but not limited to, TBK Bank Sports Complex employees, volunteers, and program participants and their families. 

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance at the TBK Bank Sports Complex. On my behalf, I thereby release, covenant not to sue, discharge, and hold harmless the TBK Bank Sports Complex, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs, or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the TBK Bank Sports Complex, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after attending any TBK Bank Sports Complex or BettPlex program or activity. 

Check this box to accept:

I Agree

Date: June 28, 2022

First Participants Name

First Name*

Last Name*

Phone*
First Participants Date of Birth*
First Participants Information
Please check the boxes of the activities in which you will participate at TBK Bank Sports Complex: *
Level II Membership
Baseball
Basketball
Football
Pickleball
Softball
Soccer
Volleyball
Wrestling
Other
First Participants Signature*
Second Participants Name

First Name*

Last Name*

Phone*
Second Participants Date of Birth*
Second Participants Information
Please check the boxes of the activities in which you will participate at TBK Bank Sports Complex: *
Level II Membership
Baseball
Basketball
Football
Pickleball
Softball
Soccer
Volleyball
Wrestling
Other
Third Participants Name

First Name*

Last Name*

Phone*
Third Participants Date of Birth*
Third Participants Information
Please check the boxes of the activities in which you will participate at TBK Bank Sports Complex: *
Level II Membership
Baseball
Basketball
Football
Pickleball
Softball
Soccer
Volleyball
Wrestling
Other
Fourth Participants Name

First Name*

Last Name*

Phone*
Fourth Participants Date of Birth*
Fourth Participants Information
Please check the boxes of the activities in which you will participate at TBK Bank Sports Complex: *
Level II Membership
Baseball
Basketball
Football
Pickleball
Softball
Soccer
Volleyball
Wrestling
Other
Fifth Participants Name

First Name*

Last Name*

Phone*
Fifth Participants Date of Birth*
Fifth Participants Information
Please check the boxes of the activities in which you will participate at TBK Bank Sports Complex: *
Level II Membership
Baseball
Basketball
Football
Pickleball
Softball
Soccer
Volleyball
Wrestling
Other
Sixth Participants Name

First Name*

Last Name*

Phone*
Sixth Participants Date of Birth*
Sixth Participants Information
Please check the boxes of the activities in which you will participate at TBK Bank Sports Complex: *
Level II Membership
Baseball
Basketball
Football
Pickleball
Softball
Soccer
Volleyball
Wrestling
Other
Seventh Participants Name

First Name*

Last Name*

Phone*
Seventh Participants Date of Birth*
Seventh Participants Information
Please check the boxes of the activities in which you will participate at TBK Bank Sports Complex: *
Level II Membership
Baseball
Basketball
Football
Pickleball
Softball
Soccer
Volleyball
Wrestling
Other
Eighth Participants Name

First Name*

Last Name*

Phone*
Eighth Participants Date of Birth*
Eighth Participants Information
Please check the boxes of the activities in which you will participate at TBK Bank Sports Complex: *
Level II Membership
Baseball
Basketball
Football
Pickleball
Softball
Soccer
Volleyball
Wrestling
Other
Ninth Participants Name

First Name*

Last Name*

Phone*
Ninth Participants Date of Birth*
Ninth Participants Information
Please check the boxes of the activities in which you will participate at TBK Bank Sports Complex: *
Level II Membership
Baseball
Basketball
Football
Pickleball
Softball
Soccer
Volleyball
Wrestling
Other
Tenth Participants Name

First Name*

Last Name*

Phone*
Tenth Participants Date of Birth*
Tenth Participants Information
Please check the boxes of the activities in which you will participate at TBK Bank Sports Complex: *
Level II Membership
Baseball
Basketball
Football
Pickleball
Softball
Soccer
Volleyball
Wrestling
Other
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/Guardian Email Address

Email*

Confirm Email*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
PARENTAL CONSENT: I am the parent or guardian of the minor named above, and I understand the nature of the above-referenced activities. I believe the minor is qualified to participate in activities at TBK Bank Sports Complex (including High 5 Lanes & Games and Level II Fitness) and verify that the minor has the appropriate experience and capabilities to participate in any activities. I hereby release, discharge, covenant not to sue and agree to defend and indemnify, save and hold harmless each of the Releasees from all liability, claims, demands, losses or damages on the minor's account caused or alleged to have been caused in whole or in part by the negligence of the Releasees or otherwise as provided above, Further, I agree that if, despite the release, I, the minor, or anyone on the minor's behalf makes a claim against any of the Releasees, I will defend, indemnify, save and hold harmless each of the Releasees from any litigation expenses, attorney fees, loss liability, damage or cost any Releasees may incur as the result of such claim.
Parent/Guardian Name

First Name*

Last Name*

Relationship*

Phone*
Parent/Guardian Date of Birth*
Parent/Guardian Information
Please check the boxes of the activities in which you will participate at TBK Bank Sports Complex: *
Level II Membership
Baseball
Basketball
Football
Pickleball
Softball
Soccer
Volleyball
Wrestling
Other
Parent/Guardian 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!