Date of
The Escape Room Westfield LLC Liability Waiver/ DBA The Escape Room Westfield
(A Legal Guardian Must Sign for a Minor)
In consideration of being permitted to engage in the following activity - Attempting to escape from a locked room which may include, but is not limited to, crouching, kneeling, climbing, crawling, and lifting (hereinafter referred to as the “Activity”) coordinated by The Escape Room Westfield LLC of 16848 Southpark Drive, Suite 100, Westfield, IN 46074 - which I acknowledge is unsupervised, I acknowledge and agree to, on my own behalf, and on behalf of my personal representatives, heirs, assigns, executors, administrators and next of kin, as follows:
If any keys, locks, or props are missing or damaged after your activity, you will be responsible for replacement of keys, locks, or props.
If we are required to cancel activities because of missing or damaged keys, locks, or props, you will be responsible for compensation for lost revenue from lost/ rescheduled ticket sales.
I am aware and acknowledge that injury or death may result from my participation in the Activity and from the use of the premises and facilities where the Activity is located or is to occur, or if premises and facilities are not an applicable description, the general area where the Activity is to occur, and the use of any machinery, equipment or apparatus located therein or thereon (collectively the “Activity Premises”).
I acknowledge that I am aware of the possible risks, dangers and hazards associated with consuming alcoholic beverages before or during my participation in the Activity. These risks include but are not limited to the following: a) the risks associated with intoxication and/or alcohol poisoning from the alcohol I consume whether voluntarily or through coercion; b) the possibility of bodily injury of any kind, including dental damages, from falling down while having to climb up and down ladders; and c) the risks associated with leaving The Escape Room’s premises, whether travelling by foot or in any kind of commercial, private and/or public motor vehicle.
Upon entering the Activity Premises, I will inspect the same and my observation and my engagement, participation and/or involvement in the Activity shall constitute an acknowledgement that I find and accept them to be safe and reasonably suited for their intended purpose.
I hereby release The Escape Room Westfield LLC of 16848 Southpark Drive, Suite 100, Westfield, IN 46074 from and against any and all liability for any loss, damage, injury, expense, demand or cause of action that I may suffer whether with respect to personal injury, death, damage to or destruction of property, theft or otherwise, which may arise as a result of my presence in, upon or about the Activity Premises or my use of the Activity Premises.
I will indemnify and hold harmless the Releasees, collectively and individually, from any and all losses, liabilities, damages, demands, costs, causes of action and expenses that they may incur, for any reason whatsoever, which may arise as a result of my participation in the Activity, and my presence in, upon or about the Activity Premises.
I acknowledge that the directors, officers, employees, volunteers, representatives, and agents of this authorizing entity are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity. The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I understand while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose this authorizing entity decides, and assigns.
I agree to pay for any damage to the room or room props if, in the opinion of management, the damage is deemed to be excessive or occurs as a result of disobeying a directive of any employee. This is in addition to and separate from missing keys, locks, or props.
!! NOTICE !! The smoke detectors and sirens in the ceilings are a part of our active fire alarm system. You are not to touch them or anything else in the ceilings. If someone touches anything on or in the ceiling that causes the fire alarm to trip or sprinklers to engage, the game is immediately over and the person who caused the system to trip will be charged for the cost of the false alarm ($500-$1000+), if we cannot cancel the false alarm in time.
I certify that I have not knowingly been exposed to COVID-19 or any other communicable illness in the past two weeks, and am not currently experiencing any feelings of illness including, but not limited to fever above 100, cough, or difficulty breathing.
I will comply with venue safety standards, including washing hands or using hand sanitizer prior to activity.
I certify that I have read this document fully and I understand its content. I am aware that this is a release of liability and a contract and I sign it of my own free will.
Please select who will be participating:
First Minor's Information
Please complete for any participant under the age of 18:
I certify that I, the below signed, am legally able to sign as the responsible party for the listed Minor(s), who are being permitted to participate in this activity. I further agree to hold harmless and indemnity Releasees from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with such participation by minor.
Second Minor's Information
Please complete for any participant under the age of 18:
I certify that I, the below signed, am legally able to sign as the responsible party for the listed Minor(s), who are being permitted to participate in this activity. I further agree to hold harmless and indemnity Releasees from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with such participation by minor.
Third Minor's Information
Please complete for any participant under the age of 18:
I certify that I, the below signed, am legally able to sign as the responsible party for the listed Minor(s), who are being permitted to participate in this activity. I further agree to hold harmless and indemnity Releasees from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with such participation by minor.
Fourth Minor's Information
Please complete for any participant under the age of 18:
I certify that I, the below signed, am legally able to sign as the responsible party for the listed Minor(s), who are being permitted to participate in this activity. I further agree to hold harmless and indemnity Releasees from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with such participation by minor.
Fifth Minor's Information
Please complete for any participant under the age of 18:
I certify that I, the below signed, am legally able to sign as the responsible party for the listed Minor(s), who are being permitted to participate in this activity. I further agree to hold harmless and indemnity Releasees from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with such participation by minor.
Sixth Minor's Information
Please complete for any participant under the age of 18:
I certify that I, the below signed, am legally able to sign as the responsible party for the listed Minor(s), who are being permitted to participate in this activity. I further agree to hold harmless and indemnity Releasees from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with such participation by minor.
Participant Age 18 or Older:
(or Legal Guardian's Information if Signing for a Minor)