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ROLLER SKATING

I understand that Roller skating is a strenuous and fast-moving physical activity which has a number of inherent risks, including, but not limited to, falling, collisions with other participants, collisions with objects, such as the floor, walls, barriers and/or dividers and other dangers which are normal and inherent risks of engaging in roller skating activities. The risk of injury from the activities involved in roller skating is significant, including the potential for serious injury, permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist and cannot be fully eliminated regardless of the care taken to avoid accidents, injury or death.

LASER TAG

I understand that Laser Tag is a strenuous and fast-moving physical activity including but not limited to, running, jumping, crawling, walking, moving through dark and unlit spaces which has a number of inherent risks, including, but not limited to, falling, collisions with other participants, collisions with objects, such as the floor, walls, barriers and/or dividers and other dangers which are normal and inherent risks of engaging in laser tag activities. The risk of injury from the activities involved in laser tag is significant, including the potential for serious injury, permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist and cannot be fully eliminated regardless of the care taken to avoid accidents, injury or death.

INDOOR PLAYGROUND AND OUTDOOR WATER SLIDE AND BOUNCE HOUSE

I understand that using the Indoor Playground, Outdoor Water Slide, Bounce House and/or other inflatable attractions is a strenuous and fast-moving physical activity including but not limited to, running, jumping, climbing, crawling, walking, moving through cramped and crowded spaces which are at and above ground level, all of which present a number of inherent risks, including, but not limited to, falling, collisions with other participants, collisions with objects, such as the floor, ground/pavement, walls, barriers and/or dividers and other dangers which are normal and inherent risks of using the Indoor Playground, Outdoor Water Slide, Bounce House and/or other inflatable attractions. The risk of injury from the activities involved in using the Indoor Playground, Outdoor Water Slide, Bounce House and/or other inflatable attractions is significant, including the potential for serious injury, permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist and cannot be fully eliminated regardless of the care taken to avoid accidents, injury or death.

SUMMER CAMP

I understand that my child’s attendance and participation in the summer or other camps offered and operated by the facility will potentially allow my child to participate in the above activities offered by the facility as a part of my child’s attendance. 


With full knowledge, understanding and appreciation of the above

1) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others, and assume full responsibility for my participation; and,

2) I willingly agree to comply with the facility's posted, stated and customary rules, terms and conditions for participation and to follow the instructions of facility personnel. If I observe any unusual hazard during my presence or participation, I will remove myself/my child from the participation and bring such to the attention of the nearest facility employee or official immediately; and

3) I certify that I am in good physical condition and am physically, mentally, emotionally and psychologically prepared and able to participate in roller skating and non-roller skating activities escribed above at Starlite Family Entertainment Ink. If I am signing this waiver, release and indemnity agreement on behalf of my child, I represent that I understand the nature of the activities offered by the facility and that my child is qualified, in good health, and in proper physical, mental and emotional condition to participate in such activity. I acknowledge that if I believe that conditions unsafe, I will immediately discontinue participation of my child in the activity and notify employees of the facility. Additionally, I agree that all undersigned and I shall use all play equipment and items appropriately, adhering to all play rules, as well as applicable size and weight limitations;

I hereby give my consent to Starlite Family Entertainment Ink to provide me and/or my child(ren), through staff of its choice, customary medical/athletic training attention, transportation and emergency medical services as warranted in the course of my/their participation.

4) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Starlite Family Entertainment Ink, its owners, officers, directors, shareholders, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, parent companies, subsidiaries, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law which may arise from my admission and participation at this event.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, AND FULLY UNDERSTAND ITS TERMS, AND FURTHER UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. I UNDERSTAND THE SERIOUSNESS OF THE RISKS INVOLVED IN PARTICIPATING IN ROLLER SKATING AND OTHER NON ROLLER SKATING ACTIVITIES WITHIN THE FACILITY AND THE POTENTIAL ADVERSE EFFECTS THAT THE CONSUPTION OF ALCOHOL MAY HAVE ON MY (AND OTHERS) ABILITY TO SAFELY PARTICIPATE IN ROLLER SKATING AND NON ROLLER SKATING ACTIVITIES. I ACCEPT PERSONAL RESPONSIBILITY FOR ADHERING TO THE APPLICABLE RULES AND REGULATIONS, AND ACCEPT THEM AS A PARTICIPANT. I AGREE THAT I AM PARTICIPATING SOLELY AT MY OWN RISK.

Parent/guardian: If participant is a minor, I verify that I am the parent or guardian of the minor, and I have authority to enter into this agreement and release liability as described and provided above on behalf of the minor.


Photo Release Form for Myself and Minor Children


I, hereby authorize the Starlite Family Entertainment Ink to publish the photographs taken of me and/or the minor child(ren) listed below, and our names, for use on the _Starlite Family Entertainment ink website, advertising materials and social media platforms. I release Starlite Family Entertainment Ink from any expectation of confidentiality for the minor children and myself and attest that I am the parent or legal guardian of the child or children listed below and that I have the authority to authorize Starlite Family Entertainment Ink to use their photographs and names. I acknowledge that since participation in publications and websites produced by Starlite Family Entertainment Ink is voluntary, neither the minor children nor I will receive financial compensation. I further agree that participation in any publication and website produced by Starlite Family Entertainment Ink confers no rights of ownership whatsoever. I release Starlite Family Entertainment Ink its officials, agents, volunteers, contractors and its employees from liability for any claims by me or any third party in connection with my participation or the participation of the minor child or children listed below.




First Participant's Name

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

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

First Name*

Last Name*

Phone*
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.
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.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
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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