Loading...

KUBE SPORTS COMPLEX LLC,  

ICE KUBE LLC, AIR KUBE LLC, STELLA ANN’S LLC, UP 4 ONE LOUNGE LLC

HAMMOND, INDIANA


WAIVER OF LIABILITY, RELEASE AND INDEMNIFICATION AGREEMENT

I, the undersigned, individually and/or as the parent or guardian of the minor child/children (hereinafter “child”) identified below will be participating in recreational activities, including but not limited to: ice hockey and/or ice skating; trampolining and/or climbing; ninja course and/or the consumption of food and/or beverages (hereinafter “activity”) at the Kube Sports Complex facility in Hammond, Indiana, beginning on the date this document is signed. I acknowledge that my participation and/or my child’s participation in the activity is totally voluntary. In consideration of the agreement by Kube Sports Complex LLC; Ice Kube LLC; Air Kube LLC; Stella Ann’s LLC; and Up 4 One Lounge LLC (hereinafter, “the Kube”) to permit me and/or my child to participate in the activity at the Kube’s facilities, the receipt and sufficiency of such consideration is hereby acknowledged, I do hereby agree to the following:

1.   I, individually, and/or on behalf of my child and our respective heirs, successors, assigns and personal representatives, hereby release and forever discharge the Kube and its employees, agents, members, officers and representatives (in their individual and official capacities) from any and all liability whatsoever, for any and all damages, injuries or losses (including death, emotional distress or mental anguish) to myself, and/or my child and my property and/or the property of my child, including but not limited to any claims, demands, causes of action, damages, losses, costs, expenses (including hospital, medical and dental expenses) and/or attorney’s fees, which arise out of, occur during, or result from my and/or my child’s participation in the activity offered by the Kube, including travel to or from the Kube’s facility and including without limitation or reservation, any claim, loss, suit or demand that my child might assert once they attain the age of majority.

2.   I, individually, and/or on behalf of my child and our respective heirs, successors, assigns and personal representatives, hereby agree to defend, indemnify and hold harmless the Kube and its employees, agents, members, officers and representatives (in their individual and official capacities) from any and all liability, loss or damages incurred or sustained (including injury or damage to persons and/or property) as a result of any claims, demands, causes of action, damages, losses costs, expenses (including hospital, medical and dental expenses) and/or attorney’s fees, which arise out of, or relate to my and/or my child’s participation in the activity, including travel to or from the Kube’s facility.

3.   I agree that this Waiver of Liability, Release and Indemnification Agreement (“Agreement”) shall be governed by the laws of the State of Indiana and is intended to be as broad and inclusive as legally permitted. If any portion thereof is deemed to be invalid, it is agreed that the remaining terms and conditions shall, notwithstanding, continue in full force and effect. In the event of any cause of action related to or arising from the activity, I agree that jurisdiction lies with the Superior Court of Lake County, Indiana, or the United States District Court for the Northern District of Indiana, Hammond Division.

4.   I hereby acknowledge and accept that there are certain risks, known and unknown, including bodily injury and death, inherent in my and/or my child’s participation in the activity. I, on my own behalf and on behalf of my child, have knowingly and voluntarily decided to assume the risks of these inherent dangers in consideration of the Kube’s permission to allow my participation and/or my child’s participation in the activity. I hereby release and discharge the Kube from any and all negligence, excluding sole negligence, in connection with my participation and/or my child’s participation in any such activity, including travel to and from the Kube’s facility. I hereby acknowledge and agree that the Kube may permit me and/or my child to engage in any activity offered by the Kube and that I assume sole responsibility for preventing me and/or my child from engaging in any activity in which I do not want to participate and/or want my child to participate.

5.   I hereby agree that, if I and/or my child engages in any activity at the Kube, I shall have sole responsibility for ensuring that I and/or my child will wear at all times any protective equipment required by the Kube for such activity, including but not limited to, a helmet that meets the USAA Hockey and or Figure Skating requirements, the safety harness for the climbing wall, and slip-resistant trampoline socks. I and/or my child also agree to abide by the Kube’s rules and regulations, including the verbal directions of the Kube’s staff. I hereby acknowledge that if I and/or my child are non-compliant with any such requirements, rules, regulations and/or directions, that may result in (a) my/our ejection from the Kube’s facility on the dates(s) on which I am and/or we are found to be in violation or (b) my and/or my child’s permanent expulsion/exclusion from said facility. I understand that the Kube Sports Complex is a privately-owned facility and that the Kube has the sole authority and discretion to determine whether I and/or my child are able to (a) enter the facility or (b) participate in any activity conducted therein.

6.   I hereby state that, as the parent or guardian of any child identified herein, I have the right and authority to (a) execute this agreement and (b) permit such child's participation in any activity offered by the Kube. It is understood that in executing this agreement, the terms of this agreement apply in the same manner to each child, if any, and me identified below.

7. By signing this agreement, I acknowledge that my presence at the Kube facility may expose me to contagious and/or infectious diseases, viruses, or other illnesses, including but not limited to COVID 19, and voluntarily assume the risk that my child and I may possibly be infected by said diseases, viruses, or illnesses; and that such exposure or infection may result in personal injury, illness, permanent disability, loss of income, and/or death. I understand that the risk of exposure may result from the actions, omissions, or negligence of myself and others, including, but not limited to the Kube personnel, employees, volunteers, spectators, program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child or myself.

8. For the purpose of this waiver, the terms: "child", "parent", "guardian" and "activity" may be understood to include the plural forms of those terms.

9.   BY SIGNING THIS WAIVER OF LIABILITY, RELEASE AND INDEMNIFICATION AGREEMENT, I HEREBY ACKNOWLEDGE AND REPRESENT THAT I HAVE READ AND INITIALED THIS ENTIRE DOCUMENT, THAT I UNDERSTAND ITS TERMS AND PROVISIONS, AND I UNDERSTAND THAT IT AFFECTS OUR RESPECTIVE LEGAL RIGHTS, THAT IT IS A BINDING AGREEMENT, AND THAT I HAVE SIGNED IT KNOWINGLY AND VOLUNTARILY.

 Please Note: All information must be complete.

Today's Date: December 25, 2024



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*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*
Check to receive information, news, and discounts by e-mail.
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Photo Release

I hereby grant permission to the Kube and its respective partners, officers, employees, agents, representatives, successors, licensees and assigns to photograph or record my images, likeness, or depiction and/or that of my minor children, if applicable. I hereby grant permission to the Kube to edit, crop, or retouch such photographs and recordings, and waive any right to inspect any of my photographs or recordings.  I hereby consent to and permit photographs or recordings of me and/or those of my minor children to be used by the Kube worldwide for any purpose, including promotional and advertisement purposes, and in any medium, including print and electronic. I understand that the Kube may use such photographs and recordings with or without associating names thereto. I further waive any claim for compensation of any kind for their use or publication of photographs and recordings   of me and/or those of my minor children, if applicable.


I hereby fully and forever discharge and release the Kube  from any claim for damages of any kind, including, but not limited to, invasion of privacy; defamation; false light or misappropriation of name, likeness, image, and right of publicity, arising out of the use or publication of photographs and recordings of me and/or those of my minor children, if applicable, by the Kube, and covenant and agree not to sue or otherwise initiate legal proceedings against the Kube for such use or publication on my own behalf or on behalf of my minor children. All grants of permission and consent, and all covenants, agreements and understandings contained herein are irrevocable.


I acknowledge and represent that I am over the age of 18, have read this entire document, that    I understand its terms and provisions, and that I have signed it knowingly and voluntarily on behalf of myself and/or my minor children, if applicable.

Please check to note your acceptance of the photo release terms. *
Agree
Disagree
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*
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!