Loading...

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 can be 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 of being on the property, and that such activities can lead to serious injury or possibly even death. Voluntarily, I am participating in 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 any and all costs that may come as a result of my participation in the yard.

          I will always release, dismiss, and agree not to sue Jackson Auto Salvage/U-Pull It and its employees for any liability claim or damages to any personal or materialistic matters that may arise from my entrance into the yard. In regards to the dangers I may be unaware of during my time at Jackson Auto Salvage/U-Pull It. I understand that I am completely responsible for myself and those I am signing for. I further agree to pay any costs related to loss, liability, damage, court costs, and attorney’s fees that Jackson Auto Salvage may require due to my participation in the U-Pull It yard.

          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 It 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 those I am signing for and myself from being on their property. Unless otherwise approved by the owner, I agree that my sole remedy against Jackson Auto Salvage/U-Pull It shall be a return of the purchase price for an in-store credit only.

          I hereby acknowledge that I am at least 18 years old and/or signing for someone under 18 years old and the result of my actions or the actions of those I am signing for falls completely under my responsibility. To the best of my ability, I have read this document and fully understand the purpose and contents of it. 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. Drugs and alcohol are prohibited in the U-Pull It, therefore, I agree that not only will I refrain from bringing any drugs and alcohol, but I also will not enter the property if I am under the influence of alcohol or drugs. I agree to follow the rules and regulations set forth by Jackson Auto Salvage/U-Pull It and understand that disobeying them can lead to immediate removal from the property or notification to the police. Due to the consideration set forth above and without any undue influence or pressure by Jackson Auto Salvage/U-Pull It or its employees, I am executing this agreement. By signing this waiver, providing my phone number, and verifying I am at least 18 years of age, 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 flames of any kind. 
  • Power cutting tools are prohibited. 
  • We have Wheel barrels available for 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 SECRETLY DURING 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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!