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ACKNOWLEDGEMENT OF RISK, WAIVER OF LIABILITY, RELEASE

 

In consideration of my ability to participate in the Island Warrior and Miniature Golf activities including Inflatables and Indoor Playground and any and all associated activities and events operated and hosted by LOST ISLAND LLC (hereinafter collectively “LILLC”) including, without limitation, driving, riding, racing, training, learning, practicing, competing, maintaining vehicles, observing, playing recreation of every type and description, and/or for any other purpose (hereinafter collectively “Events”) and in consideration of my ability to enter into or upon the premises, locations, and facilities where said Events are or will be taking place, I, for myself, my representatives, agents, assigns, successors, heirs, and next of kin hereby agree and represent as follows: 

This waiver hereby releases LILLC and its owners, employees, contractors, permittees, agents, representatives, assignees, successors, heirs, volunteers and other entities working for or with LILLC, as well as any other entities working for or with it from any and all liability, loss, damages, costs, claims and/or causes of action, including but not limited to injury to the person or property and emotional and bodily injuries, including death, including without limitation any and all liability caused or occasioned by the sole or partial fault of negligence of LILLC, arising in any way from or related to person who verbally agrees participation in and Events as herein descried, the person who agrees presence on, in, or about the premises where said Events are or will be taking place, and the person who agrees use of LILCC premises, facilities, equipment and machinery.

The written agreement acknowledges that he/she will be participating in activities, including but not limited to, Ninja Warrior Course, mini-golfing and other activities, which involve the risk of injury, death, damage, or loss that may occur as a result of his/her participation in LILLC’s activities or programs and/or the use of LILLC premises, facilities, equipment, and/or machinery. The written agreement hereby releases and holds LILLC harmless from liability for any such injury or damage, including any injury or damage that may result from LILLC’S negligence and that may occur as a result of any emergency care provided, if any. The written agreement also hereby agrees to indemnify, save, and hold harmless LILLC from any liability, loss damages, costs, claims and/or causes of action they may incur (including attorney’s fees and court costs), arising out of or related to the to the person who agrees participation in the Events or in any way related to the person who agrees presence in or upon the premises where the Events are or will be taking place, including without limitation that caused by the negligence of LILLC that occurred as a result of emergency care provided. The agreement acknowledges that the participant will follow all posted rules for the following and all activities. The agreement also agrees to pay LILLC for any and all damages to the premises, facilities, equipment and or machinery caused by the person who signed. 

The written agreement acknowledges that he/she will not participate in and Events or utilize the premises, facilities, equipment, or machinery if under the influence of alcohol or drugs or have a physical condition that would impair his/her ability to understand and follow directions and participate without creating risk to others or him/herself. It is the person whom agrees responsibility to consult with a doctor prior to participation and to participate only in those activities for which he/she has been cleared by his/her personal doctor, and possesses the required skills, qualifications, training, and physical conditioning.


In the event of an emergency requiring medical care, this agreement authorizes LILLC to use its best efforts to obtain whatever medical treatment it, in its sole discretion, deems appropriate under the circumstances, and consents to receive such medical treatment, if any. The agreement acknowledges that LILLC shall have no responsibility to pay for medical treatment and related costs in any event.

This agreement agrees that he/she may be photographed and consents to the use of any photograph, video, film or likeness to be used by LILLC for any legitimate business purpose.

This agreement that this Acknowledgement of Risk, Waiver of Liability and Release is intended to be and shall be construed as broadly and inclusively as is permitted by the law of the Commonwealth of Colorado or other applicable laws, and that it is fully severable, such that if any portion is held to be invalid, the person who verbally agreed agrees that the balance shall nonetheless continue in full force and effect. The agreement also agrees that no oral or written representations can or will alter the contents of this document.

By being on the property it is consent for the Acknowledgement of Risk, Waiver of Liability and Release, this agreement certifies:

I expressly WAIVE, RELEASE AND DISCHARGE LILLC, its officers, agents and employees or any other person from any and all LIABILITY for any death, disability, personal injury, property damage, property theft or actions, including any alleged or actual negligent act or omission, regardless of whether such act or omission is active or passive which may accrue to myself or members of my organization/ group or our heirs in connection with our participation in the above-described event. I fully understand and acknowledge that LILLC is relying on my representation that I have authorization to sign this document and that I will provide all members of my group a completed copy of this Waiver prior to our participation. I expressly INDEMNIFY AND HOLD HARMLESS LILLC, its elected and appointed officials, agents and employees from any and all liabilities or claims made by me or my organization or group, my/our heirs and any other individuals or entities as a result of any of my/ our actions in connection with my/our participation in this event except for those claims arising from the sole negligence or sole willful conduct of the following activities: inflatables, miniature golf, ninja warrior course and indoor playground, also to include any use of alcohol either brought in by others or provided by the establishment. 

I HAVE READ AND UNDERSTAND THE CONTENT OF THIS ACKNOWLEDGEMENT OF RISK, WAIVER OF LIABILITY, AND RELEASE. I AM AWARE THAT BY EXECUTING THIS AGREEMENT, I AM WAIVING CERTAIN LEGAL RIGHTS THAT I, MY CHILD, OR HEIRS, NEXT OF KIN, AGENT, ASSIGN, EXECUTORS OR ADMINISTRATORS MAY HAVE HAD AGAINST LILLC. I AM AT LEAST 18 YEARS OF AGE, POSSESS A VALID STATE DRIVER’S LICENSE, AND GIVE CONSENT. THIS RELEASE SHALL CONTINUE IN FORCE DURING THIS VISIT AND ALL FUTURE VISITS, UNLESS AND UNTIL REVOKED IN WRITING BY THE PERSON SIGNING.






First Participant Name

First Name*

Last Name*
First Participant Date of Birth*
I certify that I am 18 years of age or older
First Participant Signature*
Second Participant Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant Date of Birth*
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.


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*
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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