THANK YOU! YOUR WAIVER HAS BEEN COMPLETED!

MEMBERSHIP APPLICATION AND LIABILITY WAIVER

               Release of Liability, Waiver of Claims, Assumption of Risks and Indemnity Agreement.
                                     (hereinafter the “Release Agreement”)

BY SIGNING THIS RELEASE AGREEMENT YOU WILL WAIVE OR GIVE UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE OR CLAIM COMPENSATION FOLLOWING AN ACCIDENT PLEASE READ CAREFULLY!


TO: Pinz, LLC dba Park Ten Lanes and Axe Lanes; the Owner, Operator and Occupier of the premises where Axe Lanes axe room activities, as defined herein, take place; and all their related and associated companies and their respective owners, directors, officers, employees, agents, representatives, instructors, contractors, subcontractors, sponsors, successors and assigns (all of whom are hereinafter collectively referred to as the "Releasees").
DEFINITION
In this Release Agreement the term "Axe Lanes axe room activities" shall include all activities, events and services provided, arranged, organized, sponsored or authorized by the Releasees, including but not limited to: axe throwing events, functions and competitions; use of axes and all other related axe throwing equipment; use of premises where the axe throwing activities take place; orientation and instruction sessions; and all other related activities.
ACKNOWLEDGEMENT
I am aware that Axe Lanes axe room activities may not be supervised or monitored by professional staff, and that by signing this document I am releasing and waiving important rights.
ASSUMPTION OF RISKS
I am aware that participating in Axe Lanes axe room activities involve many risks, dangers and hazards which may result in serious injury or death including but not limited to: improper use of equipment; equipment failure; splinters, cuts, lacerations, fractures, punctures or abrasions; collision with other persons; loss of balance or control; slips, trips and falls; failure to act safely or within one’s own ability; negligence of other persons; negligent first aid and NEGLIGENCE ON THE PART OF THE RELEASEES. I UNDERSTAND THAT NEGLIGENCE INCLUDES FAILURE ON THE PART OF THE RELEASEES TO TAKE REASONABLE STEPS TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF PARTICIPATING IN AXE LANES AXE ROOM ACTIVITIES. I FREELY ACCEPT AND FULLY ASSUME ALL RISKS, DANGERS AND HAZARDS ASSOCIATED WITH AXE LANES AXE ROOM ACTIVITIES AND THE POSSIBILITY OF PERSONAL INJURY, DEATH, PROPERTY DAMAGE OR LOSS RESULTING THEREFROM.

RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT
1. I HEREBY WAIVE ANY AND ALL CLAIMS that I have or may in the future against the Releasees AND RELEASE THE RELEASEES from any and all liability for any loss, damage, expense or injury including death that I may suffer, or that my next of kin may suffer, as a result of my participation in Axe Lanes axe room activities DUE TO ANY CAUSE WHATSOEVER, INCLUDING NEGLIGENCE, BREACH OF CONTRACT OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE, ON THE PART OF THE RELEASEES with respect to the provision of or the failure to provide any warnings, directions or instructions as to the use of the axe or the risks, dangers and hazards of participating in Axe Lanes axe room activities. I UNDERSTAND THAT NEGLIGENCE INCLUDES FAILURE ON THE PART OF THE RELEASEES TO TAKE REASONABLE STEPS TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF AXE LANES AXE ROOM ACTIVITIES;
 2. I HEREBY HOLD HARMLESS AND AGREE TO INDEMNIFY THE RELEASEES from any and all liability for any property damage or personal injury to any third party resulting from my participation in Axe Lanes axe room activities;
3. This Release Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns and representatives, in the event of my death or incapacity;
 4. This Release Agreement and any rights, duties and obligations as between the parties to this Release Agreement shall be governed by and interpreted solely in accordance with the laws of the State of Mississippi and no other jurisdiction; and
5. Any litigation involving the parties to this Release Agreement shall be brought solely within Hancock County, Mississippi and shall be within the exclusive jurisdiction of the Courts of the Hancock County, Mississippi.
 PHOTO/VIDEO RELEASE 
• I hereby grant permission to the Releasees to take photographic or video representations of me during my participation in Axe Lanes axe room activities and to publish the photographs and video for advertising, promotional and marketing purposes. 
• I waive any and all claims against the Releasees arising out of the Releasees use of my photographic or video representation of me, including claims relating to defamation or invasion of any copyright, privacy, personality or publicity rights. 
• I agree not to claim compensation from the Releasees for the use of photographic or video representation of me during my participation in Axe Lanes axe room activities. In entering into this Release Agreement I am not relying on any oral or written representations or statements made by the Releasees with respect to the safety of Axe Lanes axe room activities, other than what is set forth in this Release Agreement. 
I CONFIRM THAT I HAVE READ THIS RELEASE AGREEMENT AND I AM AWARE THAT BY SIGNING THIS RELEASE AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASEES. By registering for, and participating in any of the Axe Lanes axe room activities you are indicating that you understand everything outlined in the terms and conditions of this document. BY COMPLETING THIS FORM, I HEREBY ACKNOWLEDGE THAT I AM NOT INTOXICATED OR CONSUMED ANY OTHER SUBSTANCES THAT MAY RESULT IN MY JUDGEMENT BEING IMPAIRED. I HEREBY ASSUME FULL RESPONSIBILITY FOR MY ACTIONS, RISKS, DANGERS, AND HAZARDS RESULTING FROM THE USE OF THE FACILITIES AND PARTICIPATION IN THE ACTIVITIES WHILE UNDER THE INFLUENCE OF ALCOHOL OR MIND ALTERING SUBSTANCES. I UNDERSTAND THAT I AM GIVING UP CERTAIN IMPORTANT RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNS MAY HAVE, THAT I AM AT LEAST 18 YEARS OLD AS OF THE DAY THIS DOCUMENT WAS COMPLETELY REVIEWED AND SIGNED BY ME. I FREELY ACCEPT AND ASSUME ALL RISKS, DANGERS AND HAZARDS AND THE POSSIBILITY OF RESULTING PERSONAL INJURY, DEATH, PROPERTY DAMAGE OR LOSS DIRECTLY OR INDIRECTLY ASSOCIATED WITH MY PARTICIPATION IN THE ACTIVITIES. I ACKNOWLEDGE THAT I HAVE READ THIS RELEASE AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS AND VOLUNTARILY AGREE TO ITS TERMS. This Release Agreement shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. 
By proceeding with the waiver form below, you agree that you have read the waiver details above.
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RELATIONSHIP TO PARENT OR GUARDIAN

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