Kiss My Axe - Waiver Form

YOU MUST BE 18 TO USE THIS WAIVER. IF UNDER 18 YOU NEED A PARENT TO FILL
OUT THE WAIVER FOR YOU!

READ CAREFULLY

Kiss My Axe DE LLC, for themselves, their present and former parent, subsidiaries, affiliates
and related companies and each of their respective present and former directors, officers,
shareholders, employees, volunteers, servants, agents, administrators, trustees, successors
and assigns and any party or parties who claim a right or interest through them (hereinafter, the
“Releasees”);
Recreational Axe-Throwing (the “Activity”) This Participation Agreement and Waiver and
Release of Liability is entered into between the undersigned “Participant” and Kiss My Axe,
LLC, its directors, owners, employees, volunteers, and facilities and the owners and lessors
thereof, hereinafter referred to as Kiss My Axe DE LLC or collectively as “Releasees”.
Participation in the activities of Kiss My Axe DE LLC can be HAZARDOUS AND PRESENT A
DANGER TO PARTICIPANT. If at any time the Participant believes conditions to be unsafe, he/
she will immediately discontinue further participation in the Activities.
1. In consideration for participating in the Activity on the date as set out below, which
consideration is hereby expressly accepted and acknowledged, myself as the Participant, I
HEREBY RELEASE, ACQUIT, AND FOREVER DISCHARGE, WITHOUT QUALIFICATION OR
LIMITATION AND HOLD HARMLESS the Releasees from any and all claims I may now and/or
in the future may have against the Releases, and from any and all liability, for any personal
injury, death and/or property damage, expense, and/or loss sustained by the Participant,
incurred on his/her account as a result of the Participant’s participation in the Activity due to any
cause whatsoever, including but not limited to and without limitation, negligence, gross
negligence, willful misconduct, including the failure to take reasonable steps to safeguard or
protect myself, risk, dangers, and/or hazards of participating in the Activity, and/or breach of
statutory or other duty, including duties arising from occupier's liability legislation and further
agrees that if, despite this release, the Participant or any other person makes a claim on the
Participant’s behalf against any of the Releasees, THE UNDERSIGNED WILL INDEMNIFY,
SAVE AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LIABILITY,
LITIGATION EXPENSES, ATTORNEY FEES, LOSSES, DAMAGES OR COSTS ANY MAY
INCUR AS THE RESULT OF ANY SUCH CLAIM, WHETHER ASSERTED BY THE
UNDERSIGNED, THE PARTICIPANT, OR ANOTHER PERSON.
2. THE PARTICIPANT ACKNOWLEDGES AND ACCEPTS that the Activity is inherently risky
and dangerous, and exposes the Participant to the possibility of personal injury, death, property
damage and/or loss resulting therefrom. Risks may arise out of contact and/or participation with
other participants, equipment and other mishaps. Risks may be caused by the Participant’s own
actions, or inaction, the actions or inaction of others participants, the condition of the facilities in
which the Activities take place, and/or THE NEGLIGENCE OF THE “RELEASEES.” Some Risks
cannot be predicted or controlled. There may be other risks and social and economic losses
either not known to me or not readily foreseeable at this time.
3. IT IS AGREED AND UNDERSTOOD that if the Participant commences such an action, or
takes such proceedings, and the Releasees are added to such proceeding in any manner

whatsoever, whether justified in law or not, the Participant will immediately discontinue the
proceedings and/or claims. This Release of Liability, Waiver, and Assumption of Risk shall
operate conclusively as an estoppel in the event of any claim, action, complaint or proceeding
which might be brought in the future by the Participant with respect to the matters covered by
this Release of Liability, Waiver, and Assumption of Risk. This Release of Liability, Waiver, and
Assumption of Risk may be pleaded in the event any such claim, action, complaint or
proceeding is brought, as a complete defense and reply, and may be relied upon in any
proceeding to dismiss the claim, action, complaint or proceeding on a summary basis and no
objection will be raised by the Participant in any subsequent action that the other parties in the
subsequent action were not privy to the formation of this Release.
4. THE PARTICIPANT HEREBY AGREES that this Release of Liability, Waiver, and
Assumption of Risk will be governed by applicable local Laws and that any dispute arising from
this Release of Liability, Waiver, and Assumption of Risk will be adjudicated by the State of
Delaware
5. SEVERABILITY: If any provision of this document is determined to be invalid for any reason,
such invalidity shall not affect the validity of any of the other provisions, which other provisions
shall remain in full force and effect as if this document had been executed with the invalid
provision eliminated.
PHOTOGRAPHS, VIDEOS AND RECORDINGS: I release all photos taken of me at Kiss My
Axe DE LLC. I acknowledge that BCS Axe House, LLC will own such “Images” and further grant
Kiss My Axe DE LLC permission to copyright, display, publish, distribute, use, modify, print and
reprint such Images in any manner whatsoever related to Kiss My Axe DE LLC business,
including without limitation, publications, advertisements, brochures, web site images, or other
electronic displays and transmissions thereof.
I further waive any right to inspect or approve the use of the Image by Kiss My Axe DE LLC
prior to its use. I forever release and hold Kiss My Axe DE LLC harmless from any and all
liability arising out of the use of the Images in any manner or media whatsoever, and waive any
and all claims and causes of action relating to use of the Images, including without limitation,
claims for invasion of privacy rights or publicity.
EMAIL ADDRESS: By providing my e-mail address, I am opting into the e-mailing list. my e-mail
address may be used to contact me but will not be made available to third parties.
LOST/ STOLEN ITEMS: I understand RELEASES are not responsible for any lost or stolen
items.
I, THE UNDERSIGNED PARTICIPANT, HEREBY CERTIFY THAT I AM AT LEAST 18 YEARS
OLD, THAT I HAVE COMPLETELY READ AND UNDERSTAND THIS AGREEMENT AND ITS
TERMS.

THAT PRIOR TO SIGNING THIS AGREEMENT, I WAS GIVEN THE OPPORTUNITY TO ASK
ANY QUESTIONS ABOUT THIS AGREEMENT.
I AM AWARE THAT BY SIGNING THIS AGREEMENT I ASSUME ALL RISKS.
I WAIVE AND RELEASE CERTAIN RIGHTS THAT I AND EACH OF MY HEIRS, NEXT OF
KIN, FAMILY, RELATIVES, GUARDIANS, CONSERVATORS, EXECUTORS,
ADMINISTRATORS, TRUSTEES AND ASSIGNS MAY HAVE AGAINST RELEASEES.

 

 

 

 

 

Clear Signature