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ACCIDENT WAIVER AND RELEASE OF LIABILITY & PHOTO RELEASE 

April 4, 2025

PLEASE READ CAREFULLY. THIS IS A LEGALLY BINDING AGREEMENT.

In consideration of being permitted to participate in the activities offered by Shatter Space (the "Company"), including but not limited to the use of the rage room, equipment, and facilities, I, the undersigned, for myself, my heirs, personal representatives, and assigns, hereby agree to the following:

1. Assumption of Risk

I understand and acknowledge that participating in rage room activities involves inherent risks, including, but not limited to, the risks of physical or emotional injury, damage to property, or death. I acknowledge that I am voluntarily participating in these activities and am fully aware of the risks associated with smashing objects, using blunt instruments, glass breakage, and the presence of sharp debris. I voluntarily assume all risks, including those that may arise from negligence, defective equipment, pre-existing medical conditions or other actions by the Company or its employees or of other participants. I understand that negligence on the part of the Releasees to take reasonable steps to safeguard or protect from the risks, dangers, and hazards of the rage room.

2. Release of Liability

I hereby release, waive, discharge, hold harmless, and forever discharge the Company, its owners, agents, employees, volunteers, sponsors, property owners, and all other persons or entities acting in any capacity on its behalf (collectively, the "Releasees"), from any and all claims, demands, causes of action, damages, injuries (including death), costs, and expenses, including legal fees, that I may have, now or in the future, arising from my participation in the rage room activities. I agree to the following terms: I WAIVE ANY AND ALL CLAIMS and RELEASE the RELEASEES from all responsibility for any loss, damage, expense, or injury, including death, that may occur to me or my next of kin resulting from participation in the rage room. This includes any cause of action, whether arising from NEGLIGENCE, BREACH OF CONTRACT, or ANY STATUTORY OR OTHER DUTY OF CARE, including any duty owed by the RELEASEES. I acknowledge that NEGLIGENCE here refers to any failure by the RELEASEES to take reasonable measures to protect me from the risks, dangers, and hazards associated with Shatter Space.

3. Indemnification

I agree to indemnify and hold harmless the Releasees from any and all claims, demands, losses, liabilities, or damages to any third party, including reasonable attorney's fees, arising out of my actions during participation in rage room activities, including but not limited to damage to property, bodily injury, or death.

4. Medical Treatment

I acknowledge that in the event of any injury or illness during my participation, the Releasees may render medical treatment or call for emergency medical services at their discretion. I agree to bear the full cost of any such medical services, and I release the Releasees from any liability related to such treatment or the lack thereof.

5. Fitness to Participate

I represent and warrant that I am physically and mentally capable of participating in rage room activities. I do not have any health conditions that would increase the risk of injury to myself or others. I acknowledge that it is my responsibility to consult a physician before participating in any physically demanding activity. Women who are pregnant or suspect they are pregnant, and persons who have consumed alcohol, are not recommended to engage in rage room activities.

6. Rules and Instructions

I agree to follow all rules and safety instructions provided by the Company and its employees. I understand that failure to adhere to these rules may result in my removal from the premises without a refund.

7. Use of Likeness

I grant the Company the right to use any photographs, videos, or other media captured (in video or still) during my participation in the rage room activities for advertising, promotional or marketing purposes, without compensation or royalties to me.

8. Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State of Iowa, without regard to its conflict of law principles.

9. Severability

If any provision of this Agreement is found to be invalid or unenforceable, the remaining provisions shall continue to be valid and enforceable.

By signing below, I acknowledge that I have read and understood this Liability Release and Waiver Agreement, and I voluntarily agree to all terms and conditions and waive substantial legal rights, including the right to sue.

I Agree

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
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 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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