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Fellow Earthlings Rage Room Inc. Participant Agreement.

 

Assumption of Risk, & Waiver of Liability. Please read & evaluate this document carefully before signing as it has legal consequences & will affect your legal rights. This agreement, Assumption of Risk & Waiver of Liability is by the undersigned person in favor of Fellow Earthlings Rage Room Inc & all Fellow Earthlings Rage Room Inc members, managers, officers, employees, agents, volunteers, contractors, insurers, affiliated entities, & assigns (Collectively "Fellow Earthlings Rage Room Inc"). You have the right to refuse to sign this Agreement, Assumption of Risk, & Waiver of Liability & sacrifice participation in Rage Room.

 

Assumption of Inherent Risks ( Please Initial after reading, understanding , & accepting the following)

 

In consideration of the venue, equipment, & services provided by Fellow Earthlings Rage Room Inc & my desire to participate in the activities

offered at Fellow Earthlings Rage Room Inc today &  in the future, I acknowledge, accept & agree as follows:

Activities in Fellow Earthlings Rage Room Inc are inherently risky. Such risks include (but are not limited to) flying objects & floor debris,

slipping & tripping hazards, small spaces, collisions, surprises, impacts, sharp & jagged edges, shocks, stress rebounds,

vibrations, acts & omissions by other people, changing environmental conditions, equipment  failure, physical exertion, unusual physical stresses,

loud noises, & other risks not specifically named. For myself. I freely obtain & fully take control of  such risks.

 

Fellow Earthlings Rage Room Inc offers strenuous activities that include known & unanticipated risks.

Participation is voluntary & can result in injury. I fully recognize & acquire all such possibilities.

 I agree to use Fellow Earthlings Rage Room venue, equipment & services wisely, responsibly, & safely. For myself , I agree to participate within my physical ability.

I agree to Obey all Fellow Earthlings Rage Room's Rules as related by Fellow Earthling's employees.

 

 I agree to use available protective clothing and equipment while participating in the activities offered by Fellow Earthling's Rage Room including Face Masks at all times.

Activities in Fellow Earthlings Rage Room may cause significant physical, mental, & emotional stresses. Fellow Earthlings Inc recommends consultation with a qualified physician prior to Fellow Earthling's Inc. activities.

 

Fellow Earthling's Rage Room Inc. Recommends that pregnant women should not participate in the activities offered at Fellow Earthling's Rage Room Inc.

 

Fellow Earthling's Rage Room Inc. recommends that people with medical conditions that can be triggered & or exacerbated should not participate in the activities offered at Fellow Earthlings Rage Room Inc, specifically including (but not limited to) those with asthma;

epilepsy; a cardiorespiratory issue; hypertension; mental illness ; a muscle , skeletal, or joint issue; an open wound; & others not specifically named.

People who have been advised or cautioned against the activities offered at Fellow Earthlings Rage Room Inc.

are prohibited from participating in the activities offered by Fellow Earthlings Rage Room Inc. 

 

 I confirm that I have inspected the venue, equipment, & services provided by Fellow Earthlings Rage Room Inc & based upon that inspection, found it to be PD.24433469.1 Safe & acceptable for participation.

 

Waiver of Liability (please initial after reading, understanding, & accepting the following)

IN CONSIDERATION OF THE VENUE, EQUIPMENT, & SERVICES PROVIDED BY FELLOW EARTHLINGS RAFE ROOM INC., & MY DESIRE TO PARTICIPATE IN THE ACTIVITIES OFFERED AT FELLOW EARTHLINGS RAGE ROOM INC. TODAY AND IN THE FUTURE FOR MYSELF, I AGREE TO WAIVE, RELEASE & DISCHARGE FELLOW EARTHLINGS RAGE ROOM INC. FROM ANY &  ALL CLAIMS RESULTING FROM ACTIVITIES & OR PARTICIPATION IN FELLOW EARTHLINGS RAGE ROOM INC. INCLUDING ANY & ALL CLAIMS CAUSED BY OR RELATED TO THE VENUE, EQUIPMENT & SERVICES, PROVIDED BY FELLOW EARTHLINGS RAGE ROOM INC. THIS AGREEMENT APPLIES TO CLAIMS OF PERSONAL INJURY (INCLUDING DEATH), ILLNESS, PROPERTY DAMAGE & LOSS OR THEFT OF PROPERTY.

 

Indemnification Agreement (please initial after reading, understanding, & accepting the following)

In consideration of the venue, equipment, &services provided by Fellow Earthlings Rage Room Inc, & my desire to participate in the activities offered at Fellow Earthlings Rage Room inc today & in the future for myself. I agree to hold harmless, defend, & indemnify Fellow Earthlings Rage Room Inc from any & all claims arising from activities & or  participation in Fellow Earthling's Rage Room Inc, including all such claims made by me, other participants, rescuers, & any other person.

Other Agreements (please initial after reading, understanding & accepting the following)

 I consent to recording by video, photograph, & audio during Fellow Earthling's Rage Room Inc activities & use of all such video, photographic, & audio recordings by Fellow Earthlings Rage Room Inc. Including publication upon its social media platforms. The appropriate venue for any legal action relative to any claims arising from activities & participation in Fellow Earthlings Rage Room Inc. & this Agreement, Assumption of Risk, & Waiver Of Liability in  Volusia County Florida.

The person signing this Agreement, Assumption of Risk, and Waiver of Liability must be 16yrs or older.

Today's Date: 

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

How did you hear about us?
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Second Participant's Date of Birth*
Second Participant's Information

How did you hear about us?
Third Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Third Participant's Date of Birth*
Third Participant's Information

How did you hear about us?
Fourth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Fourth Participant's Date of Birth*
Fourth Participant's Information

How did you hear about us?
Fifth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Fifth Participant's Date of Birth*
Fifth Participant's Information

How did you hear about us?
Sixth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Sixth Participant's Date of Birth*
Sixth Participant's Information

How did you hear about us?
Seventh Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Seventh Participant's Date of Birth*
Seventh Participant's Information

How did you hear about us?
Eighth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Eighth Participant's Date of Birth*
Eighth Participant's Information

How did you hear about us?
Ninth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Ninth Participant's Date of Birth*
Ninth Participant's Information

How did you hear about us?
Tenth Participant's Name

First Name*

Middle Name

Last Name*

Phone*
Tenth Participant's Date of Birth*
Tenth Participant's Information

How did you hear about us?
Participant's 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 or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

How did you hear about us?
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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