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Document ID: oqAFsuPE3SnQWvhpn9Wd4G
Completed: 2022-07-07T02:10:00+00:00 UTC
Great Room Escape and
Class Axe Throwing
San Antonio
Waiver
Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19 The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many “area’s, prohibited the congregation of groups of people.
GRE LLC,( DBA Class Axe Throwing and/or Great Room Escape), hereafter referred to as “Location”, has put in place preventative measures to reduce the spread of COVID-19; however, “Location” cannot guarantee that you and/or your child(ren) will not become infected with COVID-19. Further, attending “Location” could increase your risk and your child(ren)’s risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I and/or my child(ren) may be exposed to or infected by COVID-19 by attending “Location” and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I am familiar with the Centers for Disease Control and Prevention (“CDC”) guidelines regarding COVID-19. I acknowledge and understand that the circumstances regarding COVID-19 are changing from day to day and that, accordingly, the CDC guidelines are regularly modified and updated, and I accept full responsibility for familiarizing myself with the most recent updates. I understand that the risk of becoming exposed to or infected by COVID-19 at “Location” may result from the actions, omissions, or negligence of myself and others, including, but not limited to, “Location” employees, volunteers, and activity participants and their families.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself and/or my child(ren) (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my and/or my child(ren)’s attendance at “Location” or participation in “Location” activities (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless “Location”, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of the IP: 107.77.197.118 Email: ************@******.*** Version: 1.0.0.20190102 Page 1 of 4
“Location”, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any “Location” activities.
To the best of my knowledge, I am in good physical condition and fully able to participate in this event. I am fully aware of the risks and hazards connected with the participation in this event, including physical injury or even death, and hereby elect to voluntarily participate in said event, knowing that the associated physical activity may be hazardous to me and my property. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OR LOSS, PROPERTY DAMAGE, OR PERSONAL INJURY, INCLUDING DEATH, that may be sustained by me, or loss or damage to property owned by me, as a result of participation in this event.
General Waiver
I hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE, GRE, LLC., their subsidiaries, officers, servants, agents, and employees (hereinafter referred to as RELEASES) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, while participating in physical activity, or while on or upon the premises where the event is being conducted.
It is my expressed intent that this release and hold harmless agreement shall bind the members of my family, spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a RELEASE, WAIVE, DISCHARGE, and CONVENTION NOT TO SUE the above named RELEASES. I hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be constructed in accordance with the laws of the State of Texas. All cameras, tape recorders and video recorders (including when incorporated in cellular phones) and their use are strictly forbidden once inside of the show. You hereby grant Sunset Screams, LLC the right to use your image, likeness, actions and statements in any transmission, publication or reproduction of the show in any means or circumstances, without any further permission or compensation.
In signing this release, I acknowledge and represent that I HAVE READ THE FOREGOING Waiver of Liability and Hold Harmless Agreement, UNDERSTAND IT AND SIGN IT VOLUNTARILY as my own free act and deed; no oral representations, statements or inducements, apart from foregoing written agreements, have been made: and I EXECUTE THIS RELEASE FOR FULL, ADEQUATE AND COMPLETE CONSIDERATION FULLY INTENDING TO BE BOUND BY SAME. APPEARANCE RELEASE
For good and valuable consideration, the receipt of which from Great Room Escape, LLC.(“Company”) is acknowledged, I hereby expressly grant to Company and to Company’s assigns and to Company’s and such assigns’ employees, agents, licensees and assigns, the right to photograph, film or tape me, and to record my voice, conversations, performances, poses, acts, musical compositions, plays and appearances, and to use my picture, photographs, silhouette and other reproductions of my physical likeness and sounds as part of any still camera photograph, motion picture, film and/or video tape (hereinafter “Products”), and in connection with the exhibition, distribution, broadcasting (online, theatrically, on television or otherwise) of the Products, or any derivative works thereof, in perpetuity, and in any medium or form, whether alone or coupled together with other audio or audio-visual material, and for any advertising, promotion, or any other lawful purpose whatsoever. I expressly understand and agree that any such photograph, film, tape or other recording of my physical likeness and performances as embodied in the Products, all rights therein as embodied in the Products, and all results and proceeds derived therefrom, shall be the sole and absolute property of Company, in perpetuity, and that Company, its licensees, successors and assigns shall have the unlimited right throughout the universe to copyright and publish, exhibit or use the Products or any part thereof as set forth herein.
I agree that I will not assert or maintain against Company, and/or Company’s successors, assigns and licensees, any claim, action, suit or demand of any kind or nature whatsoever, including but not limited to those grounded upon invasion of privacy, rights of publicity, moral rights or other civil rights, or for any other reason in connection with Company’s use of my physical likeness and performances in the Products as herein provided. I hereby release Company, its successors, assigns and licensees, and each of them, from and against any and all claims, liabilities, demands, actions, causes of action, costs and IP: 107.77.197.118 Email: ************@******.*** Version: 1.0.0.20190102 Page 2 of 4 Kashida
First Name*
Flood
Last Name*
Phone*
Female
8 - August 2 2001
************@******.***
expenses whatsoever, at law or in equity, known or unknown, anticipated or unanticipated, which I ever had, now have, or may, shall or hereafter have by reason, matter, cause or thing arising out of Company’s use as herein provided. I further agree that Company may use and license others to use my name, voice, likeness and any biographical material concerning me which I may provide, in any and all media, and in the promotion, advertising, and publicizing of the Products, throughout the world in all media, by any method or device now known or hereafter devised, an unlimited number of times, and in perpetuity. I further represent that any statements made by me during my appearance are true to the best of my knowledge, and that neither they nor my appearance and performances will violate or infringe upon the rights of any third party. I hereby waive any right or inspection or approval of my appearance or the uses to which such appearance may be put. I acknowledge that Company will rely on this permission potentially, at substantial cost to Company. and hereby agree not to assert any claim of any nature whatsoever against anyone relating to the exercise of the permissions granted hereunder. I affirm that neither I, nor anyone acting for me, gave or agreed to give anything of value to any of Company’s employees or any representative of any television station, network or production entity for arranging my appearance on the Products. Dated: July 7, 2022
Participant's Name
Participant's Date of Birth*
Participant's Signature*
Email Address
IP: 107.77.197.118 Email: ************@******.*** Version: 1.0.0.20190102 Page 3 of 4 Email*
************@******.***
Confirm Email*
28423
Check to receive information, news, and discounts by e-mail. Zip Code
Activity*
Room Escape
• Axe Throwing
Are you the organizer for your group*
No
• Yes
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. IP: 107.77.197.118 Email: ************@******.*** Version: 1.0.0.20190102 Page 4 of 4
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