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Read carefully the Release of Liability Waiver below.  PLEASE NOTE, ALL WAIVERS ARE SET TO EXPIRE AFTER 6 MONTHS

1. I DO HEREBY RELEASE Rollerplex Entertainment and its directors, officers, employees, sponsors, independent contractors and agents from all
liability, and DO HEREBY WAIVE as against Rollerplex Entertainment and its directors, officers, employees, sponsors, independent contractors and
agents all recourses, proceedings, claims, and causes of action of any kind whatsoever, in respect of any and all personal injuries or property losses
which I may suffer arising out of or connected with my preparation for, or participation in Roller Skating or Motion Simulator Racing
notwithstanding that such injuries or losses may have been caused solely or partly by the negligence or breach of duty of Rollerplex
Entertainment, or any of their directors, officers, employees, sponsors, independent contractors or agents.
2. I HEREBY ACKNOWLEDGE AND AGREE THAT:
•Roller Skating or Motion Simulator Racing may be dangerous, exposing participants to many risks and hazards, some of which are inherent in the
very nature of Roller Skating or Motion Simulator Racing itself, others which result from human error and negligence on the part of the persons
involved in organizing, staging and/or operating the Roller Skating or Motion Simulator Racing; as a result of the aforesaid risks and hazards, I as a
participant may suffer serious personal injury, even death, as well as property loss; some of the aforesaid risks and hazards are foreseeable, but
others are not;
• I nevertheless freely and voluntarily assume all the aforesaid risks and hazards, and that, accordingly, my preparation for, and participation in
Roller Skating or Motion Simulator Racing shall be entirely at my own risk;
• I understand that neither Rollerplex Entertainment nor any of its directors, officers, employees, sponsors, independent contractors or agents
assume any responsibility whatsoever for my safety during the course of my preparation for or participation in Roller Skating or Motion Simulator
Racing;
• I clearly understand that Rollerplex Entertainment would not permit me to participate in Roller Skating or Motion Simulator Racing unless I
signed this RELEASE and WAIVER of LIABILITY AND ASSUMPTION of RISK AGREEMENT, and that this RELEASE and WAIVER of LIABILITY AND
ASSUMPTION of RISK AGREEMENT applies to Roller Skating or Motion Simulator Racing this RELEASE and WAIVER of LIABILITY AND ASSUMPTION
of RISK AGREEMENT is binding on myself, my heirs, my executors, administrators, personal representatives and assigns;
• I agree that I am physically capable of participating in Roller Skating or Motion Simulator Racing, and that I have no pre-existing conditions that
would hinder my ability to participate in Roller Skating or Motion Simulator Racing.
• I understand that the Motion Simulators are not for everyone due to platform motion, triple surround screen and surround sound.
• I understand that I must be able to enter and exit the Motion Simulator without using the steering wheel for support to prevent damage to this
sensitive equipment.
• I understand I must be at least 1.42m (5ft) tall to be able to reach the pedals and steering of the Motion Simulator at the same time. This is a
safety issue and we reserve the right to enforce this regulation.
• From time to time Rollerplex Entertainment or other authorised parties carry out photography and/or video recording at the Centre which may
feature visitors. By accepting these Regulations, you agree that Rollerplex Entertainment or any authorised party may use such images in
perpetuity in any promotional, advertising or publicity material in any format whatsoever. You further agree that copyright in these materials rests
with Rollerplex Entertainment or such authorised party (as the case may be).
• Epilepsy Warning: A very small percentage of individuals may experience epileptic seizures when exposed to certain patterns or flashing lights.
Exposure to certain light patterns may induce an epileptic seizure in these individuals, and certain conditions may induce undetected epileptic
symptoms even in persons who have no prior history or seizures or epilepsy. If you, or anyone in your family, has an epileptic condition, consult
your medical practitioner before racing.
• No safety, construction or utility type shoes shall be worn when using the motion simulators. The Centre personnel will advice on this.
• I will not engage in any activity that may cause damage to the property of Rollerplex Entertainment. I will take sole responsibility for the cost of
repair for such damage caused by me.
• I agree to follow and abide by the instructions of the Team Members of Rollerplex Entertainment
• I clearly understand that by signing this Agreement I will be FOREVER PREVENTED FROM SUING OR OTHERWISE CLAIMING against Rollerplex
Entertainment, its directors, officers, employees, sponsors, independent contractors and agents for any loss or damage connected with any
property loss or personal injury that I may sustain while participating in or preparing for Roller Skating or Motion Simulator Racing, whether or not
such loss or injury is caused solely or partly by the negligence of Rollerplex Entertainment or any of its directors, officers, employees, sponsors,
independent contractors and/or agents
•I have carefully read this RELEASE and WAIYER of LIABILITY AND ASSUMPTION of RISK AGREEMENT (the "Agreement"), that I fully understand
same, and that I am freely and voluntarily executing same;

I Agree

• Patron, parent or legal guardian signing this document must be at least 18 years of age.

December 2, 2021

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

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

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