Participant and/or Event Details
Emergency Contact Information
Required
If under 18, this form must be filled out by a parent or legal guardian.
*Gamewheelz is not responsible for any fraudulent information provided by a minor.
I agree that myself, my child, and/or the participants of the event I am hosting will be permitted to play the following Games and Activities while at Gamewheelz
Note About Game Rating Selections Above
If permission is not granted to play games rated "T" for Teen and/or games rated "M" for Mature, we will restrict gaming party exposure to only titles rated "E" for everyone or "10+". This will limit the console choices offered primarily to Switch, Wii U, Wii and a small amount of select titles available for PS4/XBoxOne.
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 Gamewheelz. 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 understand that Mature and Teen rated titles may be played during the experience, and that my child/children may be exposed to this content. I am fully responsible for making all parties (essentially including, but not limited to, the host parent and Gamewheelz personnel) aware of any special needs or allergies my child/children may have. The risk of serious injury from participating in Gamewheelz activities, although minimal, does exist as it does in all play and amusement activities. I agree to assume full responsibility for any personal injury I may sustain in connection with participation in interactive entertainment activities organized by Gamewheelz, and I release and discharge Gamewheelz and its owners, employees, representatives, and agents from any liability for any injuries I may sustain, including injuries caused by the negligence of Gamewheelz or its employees, representatives, or agents.
2. I agree to indemnify and defend Gamewheelz and its owners, employees, representatives, and agents against all claims, causes of action, damages, judgments, costs, or expenses, including attorney fees and other litigation costs and expenses, which may in any way arise out of my participation in interactive entertainment activities organized by Gamewheelz, including injuries caused by the negligence of Gamewheelz or its employees, representatives, or agents.
3. I agree to pay for all damages to the facilities of Gamewheelz caused by my negligent, reckless, or willful conduct.
4. I agree to observe and obey the behavior policy and all other posted rules and warnings, and to follow any oral instructions or directions given by Gamewheelz or its employees, representatives, or agents. Should I drop off my child or children in my care for a party or related activity, I will inform them not to leave the host site until I or a designated representative return to pick them up. I will inform them to follow all rules of participation as indicated by the party host and will trust their judgment or the judgment of my representative in their safe participation. I understand the Gamewheelz staff does not provide a sitting service and is not responsible for the actions of any participants.
5. Any legal or equitable claim that may arise from my participation in interactive entertainment activities organized by Gamewheelz shall be resolved under California law, with exclusive jurisdiction and venue being in the state and federal courts of the State of California.
6. 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 Gamewheelz has offered to refund any fees I have paid to use its facilities if I choose not to sign this Release.
7. 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.
8. 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 arbitrator 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 or federal courts of the State of California or a court that has jurisdiction to enter it.
9. I hereby consent to the recording of statements, photographs, and/or audio or video recordings taken of my child/children/myself at this Gamewheelz event 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 by Gamewheelz personnel. All statements, photographs, and/or audio or video recordings taken of “the Minor(s)” or me, by Gamewheelz, may be used by Gamewheelz for promotional, commercial, or other purposes as determined by Gamewheelz anywhere in the world in its sole discretion. Neither “the Minor(s)” nor I shall have any right to control the use or publication by Gamewheelz of the statements, photographs, and/or audio or video recordings. On behalf of “the Minor(s)” and myself, all statements, photographs, and/or audio/video recordings taken of “the Minor(s)” or me by Gamewheelz or its contractors shall be the sole property of Gamewheelz. Neither the Minor nor I shall receive any compensation in connection with the use of these statements, photographs, and/or audio or video recordings for promotional, commercial, or other purposes. I hereby release, waive, and discharge any claims of any kind or nature arising out of or relating to the use of the statements, photographs, and/or audio or video recordings against Gamewheelz or any person or firm authorized by Gamewheelz to publish said materials (“Publisher”). Such release, waiver, and discharge shall also extend to all affiliated companies, shareholders, directors, officers, employees, agents, and assigns of Gamewheelz and any Publisher. I further agree that Gamewheelz 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.
ESRB Awareness and Parental Consent
*Required for all participants under the age of 17
Electronic Signature and Acknowledgement