Release of Liability and Assumption of Risk

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RELEASE OF LIABILITY AND ASSUMPTION OF RISK

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I agree to the following:

1. I recognize that there are certain significant risks associated with the activities organized by Liberty City Rage Room. These risks include, but are not limited to, serious bodily injuries caused by smashing glass, plastic, metal, and/or wood items, electronics, and/or furniture. Some of the items used to smash the items may require physical exertion. I agree to assume full responsibility for any personal injury I may sustain in connection with participation in any activities organized by Liberty City Rage Room, and I release and discharge Liberty City Rage Room and Midland Charms and its owners, employees, representatives, and agents from any liability for any injuries I may sustain, including injuries caused by the negligence of Liberty City Rage Room and Midland Charms or its employees, representatives, or agents.

2. I agree to indemnify and defend Liberty City Rage Room and Midland Charms and its owners, employees, representative, and agents against all claims, causes of action, damages, judgments, cost, or expenses, including attorney fees and other litigation costs and expenses, which may in any way arise out of my participation in any activity organized by Liberty City Rage Room, including injuries caused by the negligence of Liberty City Rage Room and Midland Charms or its employees, representatives, or agents.

3. I agree to observe and obey all posted rules and warnings, and to follow any oral instructions or directions given by Liberty City Rage Room or its employees, representatives or agents.

Age Requirements and Verification

Age of Participant:*

*(ADULT PARTICIPANTS) By checking this box, I agree and acknowledge that before I am permitted to participate in any activity organized by Liberty City Rage Room that I must sign this Release of Liability form, and that by signing, I attest that I am 17 years of age or older.

(CHILD PARTICIPANTS) I agree and acknowledge that before any child under the age of 17 years is permitted to participate in any activity organized by Liberty City Rage Room, the child's legal parent or guardian must sign this form on the child's behalf, and that by signing, you attest that you are the child participant's legal guardian, you grant permission for the child to participate in the activity, and you assume all risks and release Liberty City Rage Room and Midland Charms of any liability as mentioned in paragraphs 1 and 2 above.

Electronic Signature and Acknowledgement

I acknowledge that I have read and fully understand the foregoing release of liability.

Enter your full name and the date to acknowledge your electronic signature of this document.

Participant's Full Name*

Today's Date*

Legal Guardian's Name

Electronic Signature of Adult Participant or Legal Guardian*