RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND PUBLICITY RELEASE
READ CAREFULLY—THIS AFFECTS YOUR LEGAL RIGHTS
I agree to the following:
1. I recognize that there are certain significant risks associated with the interactive entertainment activities organized by Mind Games. These risks include, but are not limited to, serious bodily injuries and/or psychological harm caused by involvement in a stressful environment that may require some physical exertion. I agree to assume full responsibility for any personal injury I may sustain in connection with participation in interactive entertainment activities organized by Mind Games, and I release and discharge Mind Games and its owners, employees, representatives, and agents from any liability for any injuries I may sustain, including injuries caused by the negligence of Mind Games or its owners, employees, representatives, or agents.
2. I agree to pay for all damages to the facilities, equipment, furniture and props of Mind Games caused by my negligent, reckless, or willful conduct.
3. I agree to observe and obey all posted rules and warnings, and to follow any oral instructions or directions given by Mind Games or its owners, employees, representatives or agents.
4. Any legal or equitable claim that may arise from my participation in interactive entertainment activities organized by Mind Games shall be resolved under Wisconsin State law with exclusive jurisdiction and venue being in the state and federal courts of the State of Wisconsin.
5. I agree and acknowledge that I am under no pressure or duress to sign this Release and that I have been given a reasonable opportunity to review it before signing. I further agree and acknowledge that I am free to have my own legal counsel review this Release if I so desire, and that Mind Games has offered to refund any fees I have paid to use its facilities if I choose not to sign this Release. I may also enter into an amended written agreement signed by myself and Mind Games owners if I desire that the terms of this waiver be changed before my acknowledgement and signing.
6. The invalidity or unenforceability of any provision of this Release, whether standing alone or as applied to a particular occurrence or circumstance, shall not affect the validity or enforceability of any other provision of this Release or of any other application of such provision, as the case may be.
7. Any controversy or claim arising out of or relating to this Release, or the breach thereof, shall be settled by arbitration administered by a single arbitration appointed by the American Arbitration Association in accordance with its Commercial Arbitration Rules, and judgment on the award rendered by the arbitrator may be entered in the State of Wisconsin, federal courts, or a court that has jurisdiction to enter it.
8. I authorize Mind Games and those acting under its authority to take images and recordings of me and to use my name, photograph, voice and/or likeness for advertising, trade and/or publicity purposes, without additional compensation, in all media now known or hereafter discovered, worldwide and on the Internet, without notice, review or approval. I further agree that Mind Games owns all images and recordings it takes of me, and I waive any and all interest in the images and recordings. The permissions granted hereby shall continue to be in force and effect forever, unless I revoke the permissions by sending a written revocation to Mind Games at 703 N. Main Street, Viroqua, WI 54665 via registered mail.
I acknowledge that I have read and fully understand the foregoing release of liability. I am of the age of 18 years or older and that I fully understand that this release cannot be modified orally.
I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I UNDERSTAND THAT BY CHECKING THE BOX BELOW, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS.
Section A: Parent/Guardian Acknowledgement For Minors
If this release is not for a minor then go to Section B.
For all persons under eighteen (18) years of age, please enter his/her name in the "Child's Name" field. By completing Section B below, I, the parent and/or legal guardian of the child(ren) named below hereby acknowledge that I am executing the foregoing Release for and on behalf of the minor(s) named herein and agree to bind myself, the minor, his/her executors, administrators, heirs, next of kin, successors, and assigns to the terms of the foregoing Release.
Section B: Electronic Signature and Acknowledgement
Enter the date and your full name to acknowledge your electronic signature of this document.
Must be parent/guardian name and signature for a minor under the age of 18.
Please sign with mouse or finger.*