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Jackson Auto Salvage, Inc.

U-Pull It Waiver

          I acknowledge and understand that an automobile salvage yard presents certain risks to me and that my presence and activities at Jackson Auto Salvage/U-Pull It are inherently dangerous activities. I acknowledge that any effort made by me to review or retrieve automobile parts from Jackson Auto Salvage/U-Pull It can be an inherently dangerous activity. I am fully aware of the dangers connected with being on the property, and that I could be seriously injured or even killed. I am voluntarily undertaking these activities with knowledge of the danger involved and assume all risks of bodily injury, death, or property damage, whether those risks are known or unknown to me. I take full responsibility to cover the cost of any  

          I forever release, discharge, and agree not to sue Jackson Auto Salvage/U-Pull It and its employees for any liability claim or damages to personal or materialistic matters that may arise from entering their salvage yard. I fully understand that I am completely responsible for myself and those I am signing for during my time at Jackson Auto Salvage/U-Pull It whether I am aware of the dangers or not. I further agree to pay any loss, liability, damage, or costs, including court costs and attorney’s fees, that Jackson Auto Salvage/U-Pull It may require due to my participation in such activity, whether caused by the negligence of their yard or otherwise.

          I acknowledge and agree that Jackson Auto Salvage/U-Pull It has no responsibility for improper installation nor for the usage of parts after the time of purchase. Jackson Auto Salvage/U-Pull is not liable for consequential damages that result from the sale or use of parts including, but not limited to, labor charges to install or remove the parts, loss of income, wages, salary, car rental charges, bodily injury, property damage or death, therefore, I hereby waive any claims that may come from being on their property. I agree that my sole remedy against Central Florida Pull and Pay, LLC shall be a return of the purchase price for an in-store credit only unless otherwise approved by the owner.

          I hereby acknowledge that I am at least 16 years old and/or signing for someone under 16 years old and that I am responsible for my actions as well as those I have signed for. I have read this document to the best of my ability to understand its purpose and contents. I have had the opportunity to further discuss this document with an employee of Jackson Auto Salvage/U-Pull It in order to have a better understanding of any questions or concerns I may have had. I also agree that I will not enter the premises if I am under the influence of alcohol or drugs. I am executing this agreement for the consideration set forth above and without any undue influence or pressure by Jackson Auto Salvage/U-Pull or its employees. By signing this waiver and providing my phone number, I acknowledge that I have read the yard rules and regulations and take full responsibility for the actions that take place on the property of Jackson Auto Salvage/U-Pull It for not only myself, but also those I have signed for. 

 

Yard Rules and Regulations:

  • Closed-toed shoes must be worn at all times. 
  • No Children under the age of 11 can be in the yard without an adult present. 
  • Anyone under the age of 16 must have an adult present to sign for them. 
  • Check the weather for your own safety, though Permission may not be granted based on weather conditions.    
  • We do not rent tools out, you must bring your own tools. 
  • No torches or flame of any kind. 
  • Power cutting tools are prohibitted. 
  • We have Wheelbarrows for Your Use.
  • Smoking/Vaping is prohibited in the yard.
  • The use of Alcohol and Drugs is not permitted and can lead to legal action if caught with anything of the sort.
  • Children cannot be left unattended in the parking lot, there must always be a guardian present.  
  • Animals may not be left in vehicles without proper care. When it is hot, the air conditioner must be on and when it is cold, they must be provided with heat. Disobeying this may lead to notifying the police to take legal authority. 

***PLEASE NOTE THAT MULTIPLE PHOTOS ARE TAKEN DISCRETELY DURRING YOUR TIME SIGNING OF THIS WAIVER***

 

First Customers: Name

First Name*

Last Name*

Phone*
First Customers: Date of Birth*
I certify that I am 18 years of age or older
First Customers: Signature*
Second Customers: Name

First Name*

Last Name*

Phone*
Second Customers: Date of Birth*
Third Customers: Name

First Name*

Last Name*

Phone*
Third Customers: Date of Birth*
Fourth Customers: Name

First Name*

Last Name*

Phone*
Fourth Customers: Date of Birth*
Fifth Customers: Name

First Name*

Last Name*

Phone*
Fifth Customers: Date of Birth*
Sixth Customers: Name

First Name*

Last Name*

Phone*
Sixth Customers: Date of Birth*
Seventh Customers: Name

First Name*

Last Name*

Phone*
Seventh Customers: Date of Birth*
Eighth Customers: Name

First Name*

Last Name*

Phone*
Eighth Customers: Date of Birth*
Ninth Customers: Name

First Name*

Last Name*

Phone*
Ninth Customers: Date of Birth*
Tenth Customers: Name

First Name*

Last Name*

Phone*
Tenth Customers: Date of Birth*
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
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*

Phone*
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.


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