PARTICIPANT AGREEMENT, RELEASE, AND ASSUMPTION OF RISK
The undersigned hereby desires to participate in ______________ (hereinafter “Event” or “Activity”) on
___________ date as an Event hosted by Kids Adventure Challenge LLC, a Utah limited liability company (hereinafter
“KAC”), not affiliated with any other company upon the following terms and conditions.
NO WARRANTY-INHERENTLY DANGEROUS ACTIVITY-NO INSURANCE PROVIDED
KAC MAKES NO WARRANTY OF ANY KIND, NATURE OR DESCRIPTION, EXPRESS OR IMPLIED, AS TO
THE SAFETY OF THE EVENT OR FITNESS FOR ANY PARTICULAR PURPOSE OF ANY PART OF THE PREMISES
FOR THE ABOVE MENTIONED EVENT COVERED BY THIS AGREEMENT. I, THE UNDERSIGNED HEREBY
ACKNOWLEDGE THAT PARTICIPATING IN SAID EVENT IS A DANGEROUS ACTIVITY WITH A RISK OF
SERIOUS BODILY INJURY OR DEATH TO OTHERS OR ONES SELF. KAC STRONGLY URGES ALL
PARTICIPANTS TO HAVE MEDICAL INSURANCE PRIOR TO ENGAGING IN THIS ACTIVITY. KAC DOES NOT
PROVIDE MEDICAL INSURANCE OR OTHER INSURANCE TO THE PARTICIPANTS AND ADVISES THAT
SERIOUS INJURIES CAN BE FINANCIALLY DEVISTATING. I PERSONALLY ACCEPT ALL RISKS AND
LIABILITY OF THIS ACTIVITY. IT HAS BEEN EXPLAINED TO ME AND I UNDERSTAND BY EXECUTING THIS
DOCUMENT I AM GIVING UP CERTAIN LEGAL RIGHTS AS PROVIDED HEREIN. IT IS MY FURTHER
INTENTION TO GIVE UP THOSE RIGHTS AND IN GOOD FAITH TO RELIEVE AND RELEASE KAC OF ANY DUTY
LEGALLY OWED TO ME IN RELATION TO THE CONDUCT OF THIS ACTIVITY.
In consideration of the services of KAC, it's agents, owners, officers, volunteers, participants, employees, and all
other persons or entities acting in any capacity on it's behalf (hereinafter collectively referred to as "KAC").
TERMS AND CONDITIONS (READ THIS CAREFULLY)
I hereby agree to release, indemnify, and discharge KAC, on behalf of myself, my spouse, my children, my parents,
my heirs, assigns, personal representative and estate as follows:
1. I acknowledge that participating in the aforementioned Event entails known and unanticipated risks that could result
in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that
such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity.
2. I expressly agree, accept, and assume all of the risks existing in this activity. My participation in this activity is purely
voluntary, and I elect to participate in spite of the risks.
3. I acknowledge that I have received a copy and read and understood all the Rules and Regulations of KAC. I will follow all the
rules and regulations posted and further agree to follow all state, federal, and local laws and regulations. If I do not follow any
Rule and Regulation of KAC, state, federal, or local law of any kind, I hold KAC harmless and release them from any claim
related thereto. I further release KAC from any and all claims if I do not follow the advice of KAC’s representatives.
4. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless KAC from any and all claims,
demands, or causes of action, which are in any way connected with my participation in this activity or my use of KAC's
equipment or facilities, including any such claims which allege negligent acts or omissions of KAC.
5. Should KAC or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I
agree to indemnify and hold them harmless for all such reasonable fees and costs. This specifically includes paying all such costs
and fees incurred by KAC.
6. I agree and covenant on behalf of myself or my child, if signing as a guardian, that I will never directly or indirectly institute any
legal, equitable, administrative, or other action, complaint, or proceeding against KAC or any members, managers, shareholders,
directors, officers, employees, agents, successors or assigns thereof, or in any matter assert any other claim or demand against
KAC and its members, managers, shareholders, directors, officers, employees, agents, successors or assigns thereof, arising from
or pertaining to the above mentioned Event. This covenant applies and extends to any all claims, liabilities, injuries, expenses,
losses, damages, and causes of action that I do not presently anticipate, know, or suspect to exist, but may develop, accrue, or be
discovered in the future.
7. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree
to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or
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physical condition I may have, and that I have disclosed any and all such conditions fully to KAC in writing.
8. In the event that I file a lawsuit against KAC, I agree to do so solely in the state of Utah, Fifth District Court, county of
Washington, and I further agree that the substantive law of Utah shall apply in that action without regard to the conflict of
law rules of that state. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining document
shall remain in full force and effect.
9. I hereby wave my rights of privacy or publicity with regard to the unconditional right to use my name, voice, photographic
likeness, video and biographical information in connection with any reproduction of the same, video\audio productions and\or
articles and press releases by KAC, their parent or affiliate companies, and those acting under their permission, anywhere at any
time, through any medium or media. I shall not be entitled to receive any royalties or other compensation in connection with such
use.
10. This agreement with attachments constitutes the entire agreement between the parties. No provision hereof may be modified or
rescinded unless in writing signed by an authorized representative of KAC and the renter.
By signing this document, I acknowledge that if anyo ne is hurt or property is damaged during my
participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against
KAC on the basis of any claim from which I have released them herein.
I have had sufficient opportunity to read this entire document and to have my counsel, attorney, or
representative read the same. I have read and understood it, and I agree to be bound by its terms.
Signature of Participant _______________________ Print Full Name _________________________
Address ___________________________________________________________________________
(Address, City, State, Zip, Country)
Home Phone _________________ Work Phone _________________ Cell Phone _________________
Date _____________ Email __________________________
PARENTS O R G UARD IAN'S ADDI TIO NA L I NDEM NIFICATIO N
(Must be completed for participants under the age of 18)
In consideration of _________________________ (print minor's name) ("Minor") being permitted by KAC to participate in
its activities and to use its equipment and facilities, I further agree to indemnify and hold harmless KAC from any and all claims
which are brought by, or on behalf of Minor, and which are in any way connected with such use or participa tion by Minor. I
further agree to be bound by all terms of the above dated Participant Agreement, Release, and Assumption of Risk as if I sign ed it
personally for myself. I further personally guarantee the payment of any and all amounts due to KAC pursuant to paragraph 5
therein.
Parent or Guardian: __________________________ Print Name: __________________________________ Date: ___________
Drivers License No. ____________________________ State _____ Date of Birth ________________
Home Phone _________________ Work Phone _________________ Cell Phone _________________
Date _____________ Email __________________________
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