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BRADENTON LOCATION:

5708 Manatee Ave W

Bradenton, FL 34209

(941)251-9385


TAMPA LOCATION:

9270 Bay Plaza Blvd., Suite 630

Tampa, FL 33619

(813) 999-1101


TREASURE ISLAND

10681 Gulf Blvd., Suite 210

Treasure Island, FL 33706

(813) 999-1101

 

RELEASE AND WAIVER OF LIABILITY

I agree that I am voluntarily participating in the activities offered by Intense Escape, LLC while using the Intense Escape, LLC facility and it is my voluntary and informed decision to release any future lawsuits or claims that I may have against the releasees (as hereinafter defined). Therefore, I agree on behalf of my personal representatives, successors and assigns to hold Intense Escape, LLC and its affiliates, officers, directors, managers, agents, employees, designers, licensors and members, as well as property owners of Intense Escape, LLC´s facility (collectively, the ¨Releasees¨) harmless from all claims or causes of action arising out of my participation in any activities at the Intense Escape, LLC facility. I expressly release and forever discharge Releasees from all liability, claims, demands or causes of action whatsoever arising out of any damage, loss, personal injury or death to me while participating in any of the activities offered by Intense Escape, LLC. This includes, without limitation, the use of electronic equipment, costumes, artwork, furniture, locking mechanisms, receiving instructions, strenuous bodily movement, and any other activities in and around the Intense Escape, LLC facility. This release is valid and effective whether the damage, loss, or death is a result of any act or omission on the part of any of the Releasees or from any other cause. This Release and Waiver of Liability includes, without limitation, injuries or accidents which may occur as a result of: a) the use or misuse of the Intense Escape, LLC facility in any way by anyone, b) the use of any equipment that malfunctions or breaks, c) improper maintenance of the facility, grounds and/or equipment, d) instruction or supervision, or e) slipping, tripping, and/or falling while in the facility or on the surrounding premises. I FURTHER GRANT TO INTENSE ESCAPE, LLC THE RIGHT TO PHOTOGRAPH, VIDEOTAPE, AND/OR RECORD ME AND TO USE MY NAME, FACE, LIKENESS, VOICE AND APPEARANCE IN CONNECTION WITH EXHIBITIONS, PUBLICITY, ADVERTISING AND PROMOTIONAL MATERIALS WITHOUT RESERVATION OR LIMITATION. I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF ALL LIABILITY AND A WAIVER OF ANY RIGHT THAT I MAY HAVE TO BRING A LEGAL ACTION OR ASSERT A CLAIM FOR INJURY OR LOSS OF ANY KIND AGAINST INTENSE ESCAPE, LLC OR ANY OF THE RELEASEES. SHOULD ANY SUCH CLAIM BE MADE, I UNDERSTAND AND AGREE THAT I WILL BE RESPONSIBLE FOR ALL ATTORNEY FEES AND DEFENSE COSTS INCURRED BY INTENSE ESCAPE, LLC AND/OR ANY OF THE RELEASEES IN CONNECTION WITH OR IN THE DEFENSE OF THAT CLAIM.

MINOR´S RELEASE: For all persons under the age of eighteen (18), a parent or legal guardian must agree to the following acknowledgment. As parent or guardian of the minors listed above, I hereby acknowledge that he/she has executed the foregoing Release for and on behalf of the minor named herein and agree to bind myself, the minor, his/her executors, administrators, heirs, next of kin, successors and assigns to the terms of foregoing Release. I hereby authorize anylicensed physician, emergency medical technician, hospital or other medical or health care facility to treat the minor names herein. I consent to the administration of all medical care necessary or appropriate in the opinion of such healthcare personnel.

First Participants Name

First Name*

Last Name*

Phone*
First Participants Age Acknowledgment*
First Participants Date of Birth*
I certify that I am 18 years of age or older
First Participants Signature*
Second Participants Name

First Name*

Last Name*
Second Participants Date of Birth*
Third Participants Name

First Name*

Last Name*
Third Participants Date of Birth*
Fourth Participants Name

First Name*

Last Name*
Fourth Participants Date of Birth*
Fifth Participants Name

First Name*

Last Name*
Fifth Participants Date of Birth*
Sixth Participants Name

First Name*

Last Name*
Sixth Participants Date of Birth*
Seventh Participants Name

First Name*

Last Name*
Seventh Participants Date of Birth*
Eighth Participants Name

First Name*

Last Name*
Eighth Participants Date of Birth*
Ninth Participants Name

First Name*

Last Name*
Ninth Participants Date of Birth*
Tenth Participants Name

First Name*

Last Name*
Tenth Participants Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Age Acknowledgment*
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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