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In consideration for Detroit Roll House, LLC (“Company”) providing access to and use of its pedal pub bike and any related services, amenities or experiences (hereinafter referred to as “Activities”), I, on behalf of myself as Participant in Activities, my heirs and my personal and legal representatives or of a minor under the age of 18 to whom I am a parent, legal guardian, or otherwise have in my care and custody and who is a Participant in Activities, and the heirs and the personal and legal representatives of said minor, hereby execute and remit this Participant Waiver of Liability and Release Form (this “Agreement”) which includes, but is not limited to, an acknowledgment of risk, a release of liability and an indemnification in favor of Detroit Roll House, LLC.

I understand and acknowledge that participating in Company Activities on the pedal pub bike are potentially hazardous to myself and to others. I, as the Participant, am subject to risk of serious injury to my person including, but not limited to, sickness, minor and/or serious bodily injury, cardiac arrest, paralysis, and/or death and/or damage to my property including, but not limited to minor property damage, irreparable destruction of property and theft (“Risk(s)”).

Acknowledgment of Risk

To the fullest extent permitted by law, as Participant or parent/guardian of a minor Participant, I hereby acknowledge the Risks described above and their inherency, and that other risks, known or unknown, inherent or otherwise, may be encountered with my use of or while present on the pedal pub bike or while at the establishments and/or locations where the pedal pub bike may visit or at any other time and any other location before, during and after Company Activities.

I expressly accept and assume all the risks, known and unknown, inherent or not, and whether or not described above, that may be encountered with my use of or while present on the pedal pub bike or while at the establishments and/or locations where the pedal pub bike may visit or at any other time and any other location before, during and after Company Activities.

Participant represents and warrants that he/she is physically fit and capable of performing the Activity he/she chooses to participate in and understands that there may be additional Risks based on his/her physical condition.

If I am the parent/guardian of a minor Participant, I have discussed the Activities, responsibilities and Risks associated with participation with the minor who understands and accepts them, and I, to the fullest extent permitted by law, accept them on behalf of such minor.

Release of Liability

Detroit Roll House, LLC, its successors, affiliates and related entities, and its respective directors, officers, members, managers, employees, volunteers, independent contractors, agents and assigns, (collectively, “Releasees”) will not be liable for any and all liability and claims arising from my participation, and my minor’s participation, including, but not limited to, all liability and claims, including attorney fees and costs, arising from personal injury (including death), accidents or illness, and damage to, loss of, or theft of property (“Claims”) or Claims of my minor Participant. On behalf of me, my heirs (including all minors), personal representatives,

  

designees and assigns, I hereby release, discharge and hold harmless Releasees from any and all Claims, whether caused by the active or passive negligence or omission of Releasees, and I covenant not to sue Releasees with respect to, and I waive any and all Claims that I may have now or in the future against Releasees for, any liability arising from my participation, or my minor’s participation, in any Activities of Releasees.

I agree to defend, indemnify and hold harmless the Releasees from and against any damage, loss, theft or destruction of any equipment and/or property, and against all accidents and losses, liability and personal and/or property and/or damages, injuries, Claims, demands, actions, causes, litigation or lawsuits, costs and expenses of every kind and nature, whether or not covered by insurance, including legal fees and disbursements, arising out of and in connection with my participation in the Activities or my presence on Company property and/or my presence at the establishments and/or locations where the pedal pub bike may visit. I assume complete and total responsibility.

Medical Emergencies

I give permission for Releasees to seek emergency medical treatment for me, if necessary and/or to seek emergency medical treatment for my minor Participant in the event Releasees are unable to reach the minor Participant’s parent/guardian. I also agree that I will be responsible for any financial debt incurred by said action.

Use of Images for Promotional Purposes

I agree that my likeness, or that of my minor Participant, may be used in Company ads, promotional videos, website and other various other marketing materials without compensation whatsoever to Participant, these images will be used for Company purposes only, and will not be given or sold to outside companies and/or individuals.

Authorization to Contact

By providing my phone number and/or email address, I authorize Company to contact me regarding promotions or special events, regardless of whether or not I am on the Do Not Call Registry.

General Provisions

I hereby expressly agree that this Waiver shall be governed by and construed in accordance with the laws of the State of Michigan, without regard to any conflict of law provisions. Company shall be entitled to attorney fees and costs incurred in the enforcement of this Waiver.

This Waiver is intended to be performed in accordance with, and only to the extent permitted by, all applicable laws, ordinances, rules, and regulations of the jurisdictions in which the Company does business. If any provisions of this Waiver or its application to any person or circumstances shall, for any reason and to any extent, be invalid or unenforceable, the remainder of this Waiver and the application of the provision to other persons or circumstances shall not be affected by it, but rather shall be enforced to the greatest extent permitted by law.

This Waiver constitutes the entire agreement among the parties hereto and contain all of the agreements among said parties with respect to the subject matter hereof. This Waiver supersedes any and all other agreements, either oral or written, between said parties with respect to the subject matter hereof.

By signing this Waiver, I acknowledge that I understand its content and that this release cannot be modified orally.

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*
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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*

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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