Ultimate Laser Tag Release
Liability Form
Save Time - print the forms and have all the release forms signed before you arrive.
Under 18 must be accompanied by an adult
THIS IS A RELEASE OF LIABILITY AND
CONSENT FORM FOR USE OF PHOTO/VIDEO IMAGES-
READ BEFORE SIGNING
THIS FORM MUST BE READ AND SIGNED BEFORE THE PARTICIPANT IS ALLOWED
TO TAKE PART IN ANY Ultimate Laser Tag/GVCM, Inc EVENT
PARTICIPANT’S NAME___________________________________DATE OF BIRTH_______________
IN CONSIDERATION of being permitted to participate in any way in the sport and activities of ULTIMATE LASER TAG under the auspices of GVCM, INC., I acknowledge, appreciate, and agree that:
1. The risk of injury from the activity and equipment of ULTIMATE LASER TAG/GVCM, Inc is significant, including the potential for permanent disability, and while particular protective equipment and personal discipline will minimize this risk, the risk of serious injury does exist;
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN ARISING FROM THE NEGLIGENCE of those persons released from liability below, and assume full responsibility for my participation; and,
3. I understand that the activities of ULTIMATE LASER TAG/GVCM, INC. are physically and mentally intense. I understand the rules of play and will comply with all the rules and regulations. If I observe any unusual or unnecessary hazard during my participation, I will bring such to the attention of the nearest official as soon as practical; and,
4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS ULTIMATE LASER TAG/GVCM INC , THE OWNERS AND LESSORS OF PREMISES USED TO CONDUCT THE LASERTAG ACTIVITES, THEIR OFFICERS, OFFICIALS, AGENTS, AND/OR EMPLOYEES ("RELEASEES"). WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH or loss or damage to person or property, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, except that which is the result of gross negligence and /or wanton misconduct.
5. I understand and agree that this Release of Liability Agreement covers each and every ULTIMATE LASER TAG/GVCM INC activity and event in which I participate hereafter.
6. I understand that there maybe photos and/or video taken of me and that these images maybe used for advertising by ULTIMATE LASER TAG/GVCM, INC. These images will be used only in good taste and in an ethical manner. I approve and give full consent to such use of my image.
I HAVE READ THIS RELEASE OF LIABLITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
X__________________________________________ Date Signed______________ Phone ___________
PARTICIPANT’S SIGNATURE
________________________________________________________________________
ADDRESS, CITY, STATE ZIP CODE
FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION)
This is to certify that I, as parent/guardian with legal responsibility for this participant do consent and agree not only to his/her release of ULTIMATE LASER TAG/GVCM, INC and all other releasees but also to release and indemnify the Releasees from any and all liabilities incident to his/her involvement in these programs for myself, my heirs, assigns, and next of kin.
X___________________________________________________________________________
PARENT/GUARDIAN’S SIGNATURE EMERGENCY PHONE #
Date Signed ______________________________