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1, (Persons who booked the event)

Am responsible for any damages caused by any employees at Dirty Birdie Lounge & Golf Bar.

1. Release of Liability, Waiver of Claims and Assumption of Risks * BY SIGNING THIS DOCUMENT, YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE OR CLAIM COMPENSATION. PLEASE READ THIS DOCUMENT CAREFULLY AND IN ITS ENTIRETY! In consideration for participating in the Activity on the date as set out below, which consideration is hereby expressly accepted and acknowledged, myself as the Participant, I HEREBY RELEASE, ACQUIT, AND FOREVER DISCHARGE, WITHOUT QUALIFICATION OR LIMITATION AND HOLD HARMLESS the

Releasees from any and all claims I may now and/or in the future may have against the Releases, and from any and all liability, for any personal injury, death and/or property damage, expense, and/or loss sustained by the Participant, incurred on his/her account as a result of the Participant’s participation in the Activity due to any cause whatsoever, including but not limited to and without limitation, negligence, gross negligence, willful misconduct, including the failure to take reasonable steps to safeguard or protect the myself, risk, dangers, and/or hazards of participating in the Activity, and/or breach of statutory or other duty, including duties arising from occupier's liability legislation and further agrees that if, despite this release, the Participant or any other person makes a claim on the Participant’s behalf against any of the Releasees, THE UNDERSIGNED WILL INDEMNIFY, SAVE AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LIABILITY,

LITIGATION EXPENSES, ATTORNEY FEES, LOSSES, DAMAGES OR COSTS ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM, WHETHER ASSERTED BY THE UNDERSIGNED, THE PARTICIPANT, OR ANOTHER PERSON.

2. THE PARTICIPANT ACKNOWLEDGES AND ACCEPTS that the Activity is inherently risky and dangerous and exposes the Participant to the possibility of personal injury, death, property damage and/or loss resulting therefrom. Risks may arise out of contact and/or participation with other participants, equipment and other mishaps. Risks may be caused by the Participant’s own actions, or inaction, the actions or inaction of others participants, the condition of the facilities in which the Activities take place, and/or THE NEGLIGENCE OF THE “RELEASEES.” Some Risks cannot be predicted or controlled. There may be other risks and social and economic losses either not known to me or not readily foreseeable at this time.

3. IT IS AGREED AND UNDERSTOOD that if the Participant commences such an action, or takes such proceedings, and the Releasees are added to such proceeding in any manner whatsoever, whether justified in law or not, the Participant will immediately discontinue the proceedings and/or claims. This Release of Liability, Waiver, and Assumption of Risk shall operate conclusively as an estoppel in the event of any claim, action, complaint or proceeding which might be brought in the future by the Participant with respect to the matters covered by this Release of Liability, Waiver, and Assumption of Risk. This Release of Liability, Waiver, and Assumption of Risk may be pleaded in the event any such claim, action, complaint or proceeding is brought, as a complete defense and reply, and may be relied upon in any proceeding to dismiss the claim, action, complaint or proceeding on a summary basis and no objection will be raised the Participant in any subsequent action that the other parties in the subsequent action were not privy to formation of this Release.

4. THE PARTICIPANT HEREBY AGREES that this Release of Liability, Waiver, and Assumption of Risk will be governed by applicable local Laws and that any dispute arising from this Release of Liability, Waiver, and Assumption of Risk will be adjudicated by the State of Wisconsin.

5. SEVERABILITY: If any provision of this document is determined to be invalid for any reason, such invalidity shall not affect the validity of any of the other provisions, which other provisions shall remain in full force and effect as if this document had been executed with the invalid provision eliminated.

PHOTOGRAPHS, VIDEOS AND RECORDINGS: I release all photos taken of me at Dirty Birdies Lounge & Golf Bar Eau Claire. I acknowledge that Dirty Birdies Lounge & Golf Bar Eau Claire will own such “Images” and further grant Dirty Birdies Lounge & Golf Bar Eau Claire. permission to copyright, display, publish, distribute, use, modify, print and reprint such Images in any manner whatsoever related to Dirty Birdies Lounge & Golf Bar Eau Claire., including without limitation, publications, advertisements, brochures, web site images, or other electronic displays and transmissions thereof.

I further waive any right to inspect or approve the use of the Image by Dirty Birdies Lounge & Golf Bar Eau Claire. prior to its use. I forever release and hold Dirty Birdies Lounge & Golf Bar Eau Claire harmless from any and all liability arising out of the use of the Images in any manner or media whatsoever, and waive any and all claims and causes of action relating to use of the Images, including without limitation, claims for invasion of privacy rights or publicity

LOST/ STOLEN ITEMS: We are not responsible for lost or stolen items. We are not responsible if your clubs hit the cage around the projectors in the golf bays.

Carry In items are not permitted- (No Food, Cakes, or Drinks)

The staff or management staff at Dirty Birdies Lounge & Golf Bar Eau Claire has the right to stop play at any time for not following rules or misconduct, with NO REFUNDS given.

The bartender or management staff at Dirty Birdies Lounge & Golf Bar Eau Claire has the right to refuse play to participants who have become intoxicated. NO REFUNDS will be given. Any Damage to the bays, equipment, or electronics will result in the credit card used for booking the bays on file. Being charged for the damages 

THE UNDERSIGNED PARTICIPANT, HEREBY CERTIFY THAT I AM AT LEAST 18 YEARS OLD. THAT I HAVE COMPLETELY READ AND UNDERSTAND THIS AGREEMENT AND ITS TERMS. THAT PRIOR TO SIGNING THIS AGREEMENT, I THE OPPORTUNITY TO ASK ANY QUESTIONS ABOUT THIS AGREEMENT. I AM AWARE THAT BY SIGNING THIS AGREEMENT I ASSUME ALL RISKS. I WAIVE AND RELEASE CERTAIN RIGHTS THAT I AND EACH OF MY HEIRS, NEXT OF KIN, FAMILY, RELATIVES, GUARDIANS, CONSERVATORS, EXECUTORS, ADMINISTRATORS, TRUSTEES AND ASSIGNS MAY HAVE AGAINST RELEASEES.



First Participant's Name

First Name*

Middle Name

Last Name*

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle 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.
Emergency Contact

First Name*

Last 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.


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*

Middle 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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