Waiver Cornbelly's

Waiver

THANKSGIVING POINT AND CORNBELLY’S RELEASE ANY WAIVER OF LIABILITY, INDEMNITY AGREEMENT AND ASSUMPTION OF RISK. READ CAREFULLY BEFORE SIGNING.
Are you or your participant(s) 16 years or younger?*

YesNo
Participant Name*

First NameLast Name
Parent/Guardian Name*

First NameLast Name
Date of participation *

MonthDayYear
Date
How many people are participating under your guardianship?*
Participant Name 1*

First NameLast Name
Participant Name 2*

First NameLast Name
Participant Name 3*

First NameLast Name
Participant Name 4*

First NameLast Name
Participant Name 5*

First NameLast Name
Participant Name 6*

First NameLast Name
Participant Name 7*

First NameLast Name
Participant Name 8*

First NameLast Name
Participant Name 9*

First NameLast Name
Participant Name 10*

First NameLast Name
I, (listed name(s) above), am aware that the CLIMBING WALL, and BUNGEE BOUNCER are HIGH INTENSITY IMPACT ACTIVITYS, and my participation in said activity is dangerous, physically demanding and hazardous, involving ricks of injury or personal property damage. The risks include, but are not limited to, injury or fatality due to physical stress and exertion, impact to activity structures and exposed objects, slipping and falling, sprains, strains, dislocations, bumps, bruises, or other injuries and other risks that may not be known. I understand that PREGNANT WOMEN and individuals with other PHYSICAL CONDITIONS or histories, which include joints, spine, heart, respiratory conditions, circulatory conditions, or other physically limiting conditions should not participate in the CLIMINB WALL. In consideration for being permitted to participate in these activities I AGREE TO: (1) RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE THANKSGIVING POINT OR CORNBELLY’S, it’s Owners, Officers, Employees, Volunteers, Vendors, Participants, etc. (Herein referred to as Releases) for ALL CLAIMNS OF LIABILITY for injury or death, property damage or other loss, now or in the future, as a result of my participation in these activities or activities incidental thereto. (2) INDEMNIFY AND HOLD HARMLESS Releasees from all claims of liability for an injury, death, property damage or other loss I incur.

I further acknowledge the dangers in the activities and I voluntarily ASSUME ALL RISKS, BOTH KNOWN AND UNKNOWN, AND ACCEPT FULL RESPONSIBILITY for injury, death, property damage or other loss. I am free of any medical condition that might create undue risk in me or others. IT IS THE INTENTION OF THIS AGREEMENT TO EXEMPT AND RELIEVE RELEASE FROM LIABILITY AND BAR ANY RIGHT TO SUE RELEASES FOR PERSONAL LOSS, INJURY, OR PROPERTY DAMAGE. I expressly agree that this release and waiver of Liability, Indemnity Agreement and Assumption of Risk Agreement is intended to be as broad and inclusive as permitted by the laws of the State of Utah and that, if any portion of the agreements is held invalid, it is agreed that the balance shall continue in full legal force and effect. I have carefully read this agreement and fully understand its contents. I AM AWARE THAT THIS IS A RELEASE AND WAIVER OF LIABILITY TO ALL RELEASEES AND THAT BY SIGNING THIS AGREEMENT I AM GIVING UP LEGAL RIGHTS. This AGREEMENT shall also bind my heirs, executors, assigns, legal representatives and family members.

(If participant is less than 16 years of age) I certify that as a Parent of Legal Guardian of this applicant that I do consent to the applicant’s participation, and further agree to be bound by each of the terms and conditions identified above..

A photo of your drivers licence is required if sumbitting off site from home.
Take photo of drivers license. *
I agree to the above terms and conditions. *

I agree
Guardian Signature *

Clear
Participant Signature*

Clear
Should be Empty: