Please read below and fill out the following information.


I ACKNOWLEDGE, agree, and represent that I understand the nature of the Activity and that I am qualified, in good health, and in proper physical, mental and emotional condition to participate in such Activity. I further agree and warrant that if, at any time, I believe the conditions to be unsafe, or if I am unfit for any component of the Activity participation, I will immediately discontinue participating in the Activity. I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY, and I am participating in the Activity entirely at my own risk. I FULLY UNDERSTAND THAT THE ACTIVITY INVOLVES RISKS AND DANGERS OF SERIOUS BODILY INJURY, including but not limited to, physical and psychological injury, emotional and physical loss, pain, suffering, illness, disfigurement, permanent or temporary disability, paralysis, and death (“Risks”). I acknowledge the Risks and other dangers may be caused by my own actions, inactions, negligence, conditions related to travel, the condition of the Premises, the actions or inactions of others participating in the Activity, the conditions in which the Activity takes place, or the negligence of the Releasees named below. I acknowledge there may be other risks or social and economic losses either not known to me or not readily foreseeable at this time. Nonetheless, I FULLY ACCEPT AND ASSUME ALL SUCH RISKS, KNOWN AND UNKNOWN, AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation, or that of the Minor named below, in the Activity, including travel to, from and during Activity. I ALSO FULLY UNDERSTAND AND ACKNOWLEDGE THAT THE ACTIVITY INVOLVES: simulated confinement in a room, mentally intense situations may be physically intense and induce stress. Physical activity may include, but not limited to, standing, bending, reaching, lifting, fast movement, limited vision, variations of lighting, feelings of pressure, enclosed space, exposure to laser lights, etc. This list is not intended to be an exhaustive list of all exposures that may incur in the Activity. I acknowledge that I have been informed by Escape This Live that if I have any health limitations then I may choose not to participate in the Activity. In the event that any damage to equipment or facilities occurs as a result of my or my family’s willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any actions of neglect or recklessness. In the event that I should require medical care or treatment, I agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance. I AND EACH OF MY HEIRS, PERSONAL REPRESENTATIVES, GUARDIANS, CONSERVATORS, AGENTS, SUCCESSORS AND ASSIGNS, AGREE TO HOLD HARMLESS AND COVENANT NOT TO SUE, AND HEREBY RELEASE AND DISCHARGE, Escape This Live, its owners, administrators, directors, managers, agents, officers, members, volunteers, employees, participants, officials, insurers, affiliates, successors and assigns, in their official and individual capacities, and owners and leasers of the Premises on which the Activity is conducted (each of the forgoing shall be considered one of the “Releasees” herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE ACTIVITY, INCLUDING THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, AND I FURTHER AGREE that if, despite this release and waiver of liability, assumption of risk, and indemnity agreement, I or anyone on my behalf makes a claim against any of the Releasees, I WILL INDEMNIFY, SAVE,AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which may be incurred as a result of such claim. Such release, discharge, and covenant not to sue to Releasees includes, without limitation, any possible legal claim for an act, or failure to act, amounting to negligence on the part of any of the Releasees. I acknowledge that the Releasees are not responsible for errors, omissions, acts or failures to act of any party or entity conducting or participating in the Activity. Escape This Live Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement with Parental Consent (“Agreement”) THIS AGREEMENT WAS ENTERED INTO WITHOUT DURESS OR COERCION, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both the Participant and Escape This Live agree that this Agreement is clear and unambiguous as to its terms, and that no other evidence will be used or admitted to alter or explain the terms of this Agreement, but that it will be interpreted based on the language in accordance with the purposes for which it is entered into. AXE THROWING AND ESCAPE ROOM – CUSTOMER WAIVER TO: Anarchy Axe Throwing and Escape This Live Escape Room and its subsidiaries, affiliates and related companies and each of their respective present and former directors, officers, shareholders, employees, volunteers, servants, agents, administrators, trustees, successors and assigns and any party or parties who claim a right or interest through them (hereinafter, the “Releasees”) RE: Recreational Axe Throwing AND Escape Room (the “Activity”) I, the undersigned desire to participate in the Activity on the date as set out below, which has been organized by the Releasees. In consideration for being allowed to participate in the Activity on the date as set out below, which consideration is hereby expressly accepted and acknowledged, on behalf of myself, my representatives, heirs, agents, administrators, trustees, executors, assigns, successors and on behalf of any party or parties who claim a right or interest through me (hereinafter, the “Releasor”). I HEREBY RELEASE, ACQUIT AND FOREVER DISCHARGE, WITHOUT QUALIFICATION OR LIMITATION the Releasees from any and all claims I may now and/or in the future may have against the Releasees, and from any and all liability, for any personal injury, death and/or property damage, expense, and/or loss sustained by me as a result of my participation in the Activity due to any cause whatsoever, including but not limited to and without limitation, negligence, gross negligence, willful misconduct, including the failure to take reasonable steps to safeguard or protect me from the risk, dangers, and/or hazards of participating in the Activity and/or breach of statutory or other duty including duties arising from occupier’s liability legislation. THE RELEASOR ACKNOWLEDGES AND ACCEPTS that the Activity is inherently risky and dangerous, and there is the possibility of personal injury death, property damage and/or loss resulting therefrom. THE RELEASOR AGREES AND UNDERSTANDS that in order to participate in the Activity on the date set out below, he/she must agree to be bound by the terms of this Release of Liability, Waiver and Assume of Risk. THE RELEASOR AGREES that he/she will be fully responsible for all costs and eXpenses that may be incurred in providing any special services to him/her, outside of regular services agreed to or provided by the Releasees in connection with the Activity, and without limiting the generality of the foregoing, agrees to be responsible for, and to pay for any and all costs relating to special travel, medical attention, or other special outlay for him/her personally, and to reimburse the Releasees for all costs of these services as may be incurred by them for his/her benefit or at his/her request. THE RELEASOR HEREBY confirms that by executing this agreement, he/she is representing that he/she is of the full age of majority and that he/she has read, and understands, this agreement. The Releasor acknowledges that he she is not under the influence of any substances, including alcohol, illicit drugs , or prescription drugs, which may affect or impair his/her motor skills, judgment, or general ability to think clearly. DocuSign Envelope ID: THE RELEASOR ACKNOWLEDGES AND ACCEPTS that any pictures or videos taken by the staff of Anarchy Axe Throwing or Escape This Live or any person(s) working under contract to them are the property of the owners/operators of Anarchy Axe Throwing and Escape This Live and may be displayed in the range, used by the owners/operators for the purposes of advertising, may be uploaded to one or more social media outlets and/or used on the Anarchy Axe Throwing or Escape This Live website, and may be used for any other form of advertising and marketing the owners of said pictures or videos see fit. IT IS AGREED AND UNDERSTOOD that the Releasor will not make any claim or take any proceedings against any other person or corporation who might claim, in any manner or forum contribution or indemnity in common law or in equity, or under the provisions of any statute or regulation, including the Negligence Act, R.S.O. 1990, c.N.l. and the amendments thereto and/or under any successor legislation thereto, and/or under the Rules of Civil Procedure, from the Releasees with respect to the matters discharged by this Release of Liability, Waiver, and Assumption of Risk. IT IS AGREED AND UNDERSTOOD that if the Releasor commences such an action, or takes such proceedings, and the Releasees are added to such proceeding in any manner whatsoever, whether justified in law or not, the Releasor will immediately discontinue the proceedings and/or claims, and the Releasor will be jointly and severally liable to the Releasees for the legal costs incurred in any such proceeding, on a substantial indemnity basis. This Release of Liability, Waiver and Assumption of Risk shall operate conclusively as an estoppel in the event of any claim, action, complaint or proceeding which might be brought in the fixture by the DocuSign Releasor with respect to the matters covered by this Release of Liability, Waiver, and Assumption of Risk. This Release of Liability, Waiver and Assumption of Risk may he pleaded in the event any such claim, action, complaint or proceeding is brought, as a complete defense and reply and may be relied upon in any proceeding to dismiss the claim, action, complaint or proceeding on a summary basis and no objection will be raised by the Releasor in any subsequent action that the other parties in the subsequent action were not privy to formation of this Release. THE RELEASOR ACKNOWLEDGES that this Release of Liability, Waiver and Assumption of Risk contains the entire agreement between the parties hereto, that the terms of this Release of Liability, Waiver and Assumption of Risk are contractual are not a mere recital and any breach of these terms may be enforced against the Releasor, and may give rise to a damage claim against the Releasor enforceable by a further legal proceeding. The Releasor further acknowledges that the Releasees have not made any oral, written or visual representations or statements that are not otherwise reflected in this agreement. I, THE UNDERSIGNED PARTICIPANT, OR THE PARENT/GUARDIAN OF THE MINOR, CERTIFY THAT I HAVE READ THE ENTIRETY OF THIS AGREEMENT AND FULLY UNDERSTAND ITS TERMS. I understand that I have given up substantial rights by signing this agreement. I am aware that this is a release of liability and a contract and that I am signing it of my own free will without any inducement or assurance of any nature and I intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law. I ADDITIONALLY PERMIT ESCAPE THIS LIVE AND THEIR AFFILIATES TO PHOTOGRAPHY AND/OR VIDEOTAPE ME OR THE MINORS PARTICIPATION IN THE ACTIVITY, including sound and video recordings. I GIVE ESCAPE LABS LLC ALL RIGHTS TO MARKET, PUBLISH, REPRODUCE (IN ANY AND ALL MEDIA), AND OTHERWISE USE THE RECORDINGS WITHOUT MY PERMISSION. I ACKNOWLEDGE THAT BY ENTERING MY NAME BELOW IT WILL BE CONSIDERED MY ELECTRONIC SIGNATURE.