Woodchucks - Waiver Form

RELEASE, WAIVER of LIABILITY, ASSUMPTION of RISK AND INDEMNITY AGREEMENT The individual named below (referred to as “Participant” or "I" or "me" or "(s)he") desires to participate in recreational axe throwing and axe throwing related activities (the "Activity") provided by Woodchucks1, LLC, a Mississippi Limited Liability Company with its principal place of business located at 304 West Main Street in Senatobia, Tate County, Mississippi (the "Company" or "Releasee(s)"). As lawful consideration for being permitted by the Company to participate in the Activity, I agree to all the terms and conditions set forth in this agreement (the "Agreement"). I am aware and understand that the activity is dangerous and involves significant risk of serious injury and/or permanent paralysis and/or death and/or property damage. I understand that such risks may be foreseeable or unforeseeable, and may include, but are not limited to: failure of safety barriers, equipment malfunction, mis-thrown axes by employees or participants and other potential risks, hazards and dangers that are integral to the activity. I represent that I am in good health and in sufficient physical condition in order to properly participate in the activity. I acknowledge that I am voluntarily participating in the activity with full knowledge of the danger involved. IN CONSIDERATION of being permitted to compete, officiate, observe, work, or participate in any way in the activity, I hereby agree and contract on behalf of myself, my estate, my personal representatives, heirs, and next of kin as follows: 1. I HEREBY WAIVE AND RELEASE any all claims that I might have for my participation in the Activity, whether known or unknown, against the Company and its officers, directors, owners, employees and/or agents as well as its affiliates, promoters, marketers, successors, assigns and leasees of the premises used to conduct the Activity and also the consultants and others who give recommendations, directions, or instructions or engage in risk evaluation or loss control activities regarding the premises or Activity and their directors, officers, agents and employees, all herein referred to as “Releasees,” and further COVENANT NOT TO SUE said Releases for any and all loss or damage that I might sustain arising out of my participation in the Activity whether caused by the negligence of the Releases or otherwise. 2. I hereby agree to INDEMNIFY AND HOLD HARMLESS the Releasees from any loss, liability, damage or cost of any kind that they may incur arising out of or related to my injury or death whether caused by the negligence of the Releasees or otherwise. 3. I hereby agree to ACCEPT AND ASSUME ALL RISK of injury, death or property damage whether caused by the negligence of the Releasees or otherwise. 4. I hereby agree that this Release, Waiver of Liability, Assumption of Risk and Indemnity Agreement extends to all acts of negligence by the Releasees, including negligent rescue operations, and is intended to be as broad and inclusive as is permitted by the laws of the State or jurisdiction in which the Activity is conducted. If any term or provision of this Agreement is invalid, illegal, or unenforceable in any jurisdiction, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this Agreement or invalidate or render unenforceable such term or provision in any other jurisdiction. This Agreement is binding on and shall inure to the benefit of the Company and myself as well as our respective successors and assigns. All matters rising out of or relating to the Agreement shall be governed by and construed in accordance with the laws of the State of Mississippi. Any claim or cause of action arising out of this Agreement or my participation in the Activity may only be brought in the Federal or State courts located in Tate County, Mississippi and I hereby consent to the exclusive jurisdiction of such courts. 5. I grant Company the right to photograph, videotape, and/or record me and to use my name, face, likeness, voice and appearance in connection with exhibitions, publicity, advertising and promotional materials without reservation or limitation. I further agree and acknowledge that my signature hereto may either be electronic in nature or by physical means and that either method of signature used by me shall be conclusively binding as stated herein. I HAVE READ THIS RELEASE, WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE OR GUARANTEE BEING MADE TO ME AND I INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

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