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Retro Putt Indoor Mini Golf

1417-1 South Orange Avenue

Green Cove Springs, FL 32043

PARTICIPANT LIABILITY WAIVER AND AGREEMENT


PARTICIPANT LIABILITY WAIVER AND AGREEMENT TO ASSUME RISK, RELEASE, AND INDEMNIFY


In consideration for being permitted to enter the premises and/or use the facilities, equipment, attractions, and services of Retro Putt at the Cove, LLC (“Retro Putt”), I voluntarily acknowledge and agree to the following terms.

SECTION 1 - GENERAL RELEASE

By signing this waiver, the signer acknowledges and agrees to the following terms on behalf of the applicable participant(s). This Agreement is intended to provide a release of liability and other legal protections to Retro Putt, together with its applicable owners, officers, managers, employees, agents, affiliates, volunteers, contractors, insurers, successors, and other parties acting on its behalf (collectively, the “Retro Putt Releasees”).

SECTION 2 - ACKNOWLEDGMENT OF RISKS

Participation in mini golf and presence at the Retro Putt premises involve risks, including known and unknown risks. These may include slips, trips, falls, collisions with people or objects, use or malfunction of equipment, actions of other guests, and other conditions associated with participating in or observing activities at the facility. Such risks may result in property damage, bodily injury, serious injury, illness, disability, or death.

SECTION 3 - VOLUNTARY ASSUMPTION OF RISK

The participant voluntarily chooses to participate in or observe activities at Retro Putt with knowledge of the risks described above and assumes the risks associated with participation, presence on the premises, and use of Retro Putt’s facilities and equipment to the fullest extent permitted by Florida law.”

SECTION 4 - RELEASE OF LIABILITY

To the fullest extent permitted by Florida law, the participant releases, waives, and discharges the Retro Putt Releasees from claims arising from participation in activities at Retro Putt or presence on the premises, including claims for personal injury, death, illness, or property damage that are legally capable of being released in advance.”

SECTION 5 - MEDICAL ASSISTANCE

If a participant becomes injured or ill while at Retro Putt, Retro Putt personnel are authorized to obtain or request reasonable emergency medical assistance when circumstances reasonably appear to require it. Retro Putt does not provide medical care, and responsibility for costs associated with medical treatment remains with the participant or the participant’s parent/legal guardian, as applicable.

SECTION 6 - REPORTING AN INCIDENT

Any injury, accident, or significant incident occurring on the premises should be promptly reported to a Retro Putt team member so that the incident can be appropriately documented and addressed.

SECTION 7 - GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the State of Florida.

First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Parent / Natural Guardian Email Address
Email
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.

PARENT / NATURAL GUARDIAN CERTIFICATION


The Florida minor-participant release used by Retro Putt is intended to be completed by a natural guardian of the minor child. Do not list a child for whom you do not have authority to sign the release. If you are bringing another family's child to Retro Putt, that child's parent/natural guardian should complete a separate waiver for that child.


FLORIDA MINOR CHILD PARTICIPANT RELEASE


I am the natural guardian of each minor child identified in this waiver. On behalf of each listed minor child, I voluntarily waive and release in advance claims or causes of action against the applicable Retro Putt released parties for personal injury, including death, or property damage resulting from inherent risks of the activity to the extent permitted by Florida Statute §744.301(3).


NOTICE TO THE MINOR CHILD’S NATURAL GUARDIAN


READ THIS FORM COMPLETELY AND CAREFULLY.

YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY.

YOU ARE AGREEING THAT, EVEN IF RETRO PUTT AT THE COVE, LLC USES REASONABLE CARE

IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED

OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS

INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED.


BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD’S RIGHT AND YOUR RIGHT TO RECOVER

FROM RETRO PUTT AT THE COVE, LLC IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH,

TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART

OF THE ACTIVITY.


YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND RETRO PUTT AT THE COVE, LLC HAS THE RIGHT

TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.




ACKNOWLEDGMENT — MYSELF + CHILDREN


By signing below, I confirm that I am 18 years of age or older, that I have read and understand

the Adult Participant Liability Waiver and the Florida Minor Child Participant Release presented

to me, and that I am signing the applicable minor release as natural guardian of each minor child

identified in this submission.


Parent / Natural Guardian Name
First Name*
Last Name*
Relationship*
Phone*
Parent / Natural Guardian Date of Birth*
Date of Birth
Parent / Natural 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.


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