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FOR PARTICIPANTS UNDER 18 YEARS OF AGE AXE-CADE, LLC WARNING, ASSUMPTION of RISK, LIABILITY RELEASE,INDEMNITY, and HOLD HARMLESS AGREEMENT

PLEASE READ CAREFULLY BEFORE SIGNING. THIS IS A RELEASE OF LIABILITY AND WAIVER OF CERTAIN LEGAL RIGHTS.


The person under 18 years of age who is participating in the rage/smash room and related activities (the “Activities”) using equipment (the “Equipment”) provided by the Axe-cade, LLC at 136 E. Main Street, Anamosa, Iowa shall be referred to as “MINOR PARTICIPANT”.

The PARENT and/or LEGAL GUARDIAN understands that the Activities and the use of the Equipment are dangerous activities and involve the significant risk of serious injury and/or permanent paralysis and/or death and/or property damage. Such risks may be foreseeable or unforeseeable, and may include, but are not limited to: Failure of any safety barriers or other safety measures, equipment malfunction, miss-thrown axes by employees or participants, mishandling of the Equipment by employees or participants, and other such risks, hazards and dangers that are integral to the use of the Equipment and to axe throwing, whether in an indoor axe throwing facility or outdoors. I also understand that alcoholic beverages may be consumed on the premises by other participants and spectators. I acknowledge that any injuries that MINOR PARTICIPANT sustains may be compounded by negligent emergency response or rescue operations of the company or others. I acknowledge that MINOR PARTICIPANT is voluntarily using the Equipment and participating in the Activities with knowledge of the danger involved and MINOR PARTICIPANT hereby agrees to accept and assume any and all risks of injury, death, or property damage, whether caused by the negligence of the company or otherwise.

In consideration for allowing the MINOR PARTICIPANT to participate in the ACTIVITY, THE UNDERSIGNED PARENT and/or LEGAL GUARDIAN hereby ASSUMES ALL RISKS associated with the MINOR PARTICIPANT’s participation in the ACTIVITY. Additionally, THE UNDERSIGNED PARENT and/or LEGAL GUARDIAN AGREES TO HOLD HARMLESS, DEFEND, AND INDEMNIFY Axe-cade, LLC, its insurance carriers, agents, employees, representatives, officers, directors, and member/owners (each hereinafter a "RELEASED PARTY") FOR ANY AND ALL LIABILITY and/or claims for injury or death to persons or damage to property arising from or relating to the UNDERSIGNED MINOR PARTICIPANT's participation in the ACTIVITY, including those claims based on any RELEASED PARTY's alleged or actual NEGLIGENCE or BREACH OF any express or implied WARRANTY.

THE UNDERSIGNED PARENT and/or LEGAL GUARDIAN takes full responsibility for any injury or loss to MINOR PARTICIPANT, including death, which MINOR PARTICIPANT may suffer, arising in whole or in part out of the ACTIVITY. By signing this release, THE UNDERSIGNED PARENT and/or LEGAL GUARDIAN AGREES that neither the undersigned or the MINOR PARTICIPANT will SUE any RELEASED PARTY and agrees they he/she is releasing any right to make a claim or file a lawsuit against any RELEASED PARTY. THE PARENT and/or LEGAL GUARDIAN further AGREES TO DEFEND AND INDEMNIFY each RELEASED PARTY for any and all claims of the MINOR PARTICIPANT and/or a THIRD PARTY arising in whole or in part from the MINOR PARTICIPANT’s participation in the ACTIVITY. THE UNDERSIGNED PARENT and/or LEGAL GUARDIAN agrees to pay all costs and attorney’s fees incurred by any RELEASED PARTY in defending a claim or suit brought by or on behalf of the MINOR PARTICIPANT.

THE UNDERSIGNED PARENT and/or LEGAL GUARDIAN represents that the MINOR PARTICIPANT is in good health and there are no special problems associated with his/her care. THE UNDERSIGNED PARENT and/or LEGAL GUARDIAN authorizes any RELEASED PARTY and/or their authorized personnel to call for medical care for the MINOR PARTICIPANT or to transport the MINOR PARTICIPANT to a medical facility or hospital if, in the opinion of such personnel, medical attention is needed. THE UNDERSIGNED PARENT and/or LEGAL GUARDIAN agree that upon the MINOR PARTICIPANT's transport to any such medical facility or hospital that the RELEASED PARTY shall not have any further responsibility for the MINOR PARTICIPANT. Further, THE UNDERSIGNED PARENT and/or LEGAL GUARDIAN agrees to pay all costs associated with such medical care and related transportation provided for the MINOR PARTICIPANT and shall hold harmless, release, defend, and indemnify the RELEASED PARTY from any costs incurred therein, or any claims arising therefrom.

In consideration for allowing the MINOR PARTICIPANT to participate in the ACTIVITY and for using Equipment, THE UNDERSIGNED PARENT and/or LEGAL GUARDIAN agree that ANY AND ALL CLAIMS for injury and/or death arising from the MINOR PARTICIPANT's participation in the ACTIVITY shall be GOVERNED BY IOWA LAW and EXCLUSIVE JURISDICTION of any claim shall be in the IOWA DISTRICT COURT in JONES COUNTY.

This release shall be binding to the fullest extent permitted by law. If any part of this release is deemed to be unenforceable, the remaining terms shall be an enforceable contract between the parties. This release shall be binding upon the MINOR PARTICIPANT, assignees, subrogors, distributors, heirs, next of kin, executors and personal representatives of THE MINOR PARTICIPANT and the PARENT and/or LEGAL GUARDIAN.

I HAVE CAREFULLY READ THE FOREGOING LIABILITY RELEASE, UNDERSTAND ITS CONTENTS, AND AM AWARE THAT I AM RELEASING CERTAIN LEGAL RIGHTS THAT I OTHERWISE MAY HAVE.
 

Date: August 19, 2022

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
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*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Media Release
I agree to let Axe-cade, LLC, use any photos or videos from the minor listed in this waiver visit to the establishment at 136 E. Main Street, Anamosa, IA 52205.*
No
Yes
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*

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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