YOU MUST BE 18 TO USE THIS WAIVER.

IF UNDER 18 YOU NEED A PARENT TO FILL OUT THE WAIVER FOR YOU!

READ CAREFULLY

WAIVER AND RELEASE OF LIABILITY

This waiver is valid for one year from the date signed.

In consideration of Copper State Axe Throwing LLC (herein after referred to as Copper State) furnishing services and/or

equipment to enable me, or the

minor(s) I am signing for, to participate in Axe Throwing I agree as follows:

I fully understand and acknowledge that; (a) risks and dangers exist in my use of Axe Throwing equipment and my

participation in Axe Throwing

activities; (b) my participation in such activities and/or use of such

equipment may result in my injury or illness including but not limited to

bodily injury, disease strains, fractures, partial and/or total paralysis, eye

injury, blindness, heat stroke, heart attack, death or other ailments that

could cause serious disability; (c) these risks and dangers may be caused by

the negligence of the owners, employees, officers or agents of Copper State;

the negligence of the participants, the negligence of others, accidents,

breaches of contract, the forces of nature or other causes. These risks and

dangers may arise from foreseeable or unforeseeable causes; and (d) by my

participation in these activities and/or use of equipment, l hereby assume all

risks and dangers and all responsibility for any losses and/or damages, whether

caused in whole or in part by the negligence or other conduct of the owners,

agents, officers, employees of Copper State, or by any other person

I, ON BEHALF OF MYSELF, MY PERSONAL AND MY

HEIRS, HEREBY VOLUNTARILY AGREE TO RELEASE, WAIVE, DISCHARGE, HOLD HARMLESS,

DEFEND AND INDEMNIFY COPPER STATE AND IT'S

OWNERS, AGENTS, OFFICERS, AND

EMPLOYEES FROM ANY AND ALL CLAIMS, ACTIONS, OR LOSSES FOR BODILY INJURY,

PROPERTY DAMAGE, WRONGFUL DEATH, LOSS OF SERVICES OR OTHERWISE WHICH MAY ARISE

OUT OF MY USE OF AXE THROWING EQUIPMENT OR MY PARTICIPATION IN AXE THROWING

ACTIVITIES. I SPECIFICALLY UNDERSTAND THAT I AM RELEASING, DISCHARGING AND

WAIVING ANY CLAIMS OR ACTIONS THAT I MAY HAVE PRESENTLY OR IN THE FUTURE FOR

NEGLIGENT ACTS OR OTHER CONDUCT BY THE OWNERS, AGENTS, OFFICERS OR EMPLOYEES OF

COPPER STATE.

MEDICAL PERMISSION AUTHORIZATIONIf the participant is of minority age, the undersigned parent or guardian hereby given permission for Copper State to

authorize emergency

medical treatment as may be deemed necessary for the child named below while

participating in Axe Throwing from this date on.

I HAVE READ THE ABOVE WAIVER AND RELEASE AND BY SIGNING IT AGREE

IT IS MY INTENTION TO EXEMPT AND RELIEVE COPPER STATE FROM LIABILITY FOR

PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY

OTHER CAUSE.

I further agree that I have read, and will adhere to all Safety Rules for the Copper State Facility / Trailer, and I have watched

or read the safety

briefing, either on line, or at the facility.

I understand that violation of any of the other safety rules outlined in the Safety Briefing, is grounds for immediate

suspension of playing privileges without any refund.

I understand that as a public facility,

pictures and or video may be taken by Copper State staff or others, and I grant

them the right to publish, and re-publish video, photographic portraits, or

pictures of me in which I may be included, in whole or in part.

I understand that this facility allows no outside axes or personal weapons of any kind on the premises. I agree that violation

of any of

the Copper State rules is grounds for immediate expulsion By hitting accept and or signing this paper copy, you

are consenting to the use of your electronic signature in lieu of an original

signature on paper. You have the right to request that you sign a paper copy

instead which is available at our location. By hitting accept, you are waiving

that right. After consent, you may, upon written request to us, obtain a paper

copy of an electronic record. No fee will be charged for such copy and no

special hardware or software is required to view it. Your agreement to use an

electronic signature with us for any documents will continue until such time as

you notify us in writing that you no longer wish to use an electronic signature.

There is no penalty for withdrawing your consent. You should always make sure

that we have a current email address in order to contact you regarding any

changes, if necessary.