Complete a waiver for myself
Complete a waiver for myself and children

Adult Information

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( Age must be at least 18 years old )

Contact Information

Waiver HCAP

Please read the waiver below and fill out the required fields found in the following form sections. All liability language from the waiver will apply to all persons listed below.

Test........

RO CITY ADVENTURE PARK IN. RELEASE OF LIABILITY, ASSUMPTION OF RISK, INDEMNITY AND HOLD HARMLESS AGREEMENT

 

***PLEASE READ CAREFULLY***

 

1190 North Kinzie ave Bradley,IL 60915

 

 

In consideration of being permitted by HERO CITY ADVENTURE PARK INC. (“HCAP’S”) to participate in its amusement activities and to use its equipment and facilities, I, both individually and on behalf of my estate, any legal heirs or assigns, and any minor child(ren) for whom I am the parent or legal guardian and as identified at the end of this agreement (collectively, “Me,” “My,” or “I”) hereby agree to the terms and conditions stated herein and further agree to forever release, discharge, indemnify and hold harmless HCAP’S, its agents, owners, members, shareholders, directors, employees, volunteers, manufacturers, participants, lessors, insurers, related and affiliated entities, successors and assigns (collectively, the “RELEASED PARTIES”) for any and all claims, causes of action, rights of action, judgments, or damages as follows:

 

1. I represent that I am eighteen (18) years old, or older, and have the capacity to consent to the terms of this Release of Liability, Assumption of Risk, Indemnity and Hold Harmless Agreement (the Agreement”).

 

2. I understand and acknowledge that I was either shown or offered to be shown a copy of the applicable rules governing guest conduct at the HCAP’S facility and that I hereby fully accept responsibility for My conduct and My actions while at a HCAP’S facility.

 

3. I understand and acknowledge that prior to engaging in the Activities, I was provided the opportunity to carefully inspect the equipment and materials (collectively, the “Equipment”) in the HCAP’S facility and consider the Equipment to be safe, free of visible defects, and reasonably suited for the Activities (defined below).

 

4. I understand and acknowledge that My participation in the games and amusement activities offered by HCAP’S, including, but not limited to, Laser Tag, Soft Playground, Slides, Foam Archery, Air Tube Bumper Car and Riding Toys (collectively, “Activities”) entails inherent risks, both known and unknown including, but  not  limited to, risk of any bodily injury, permanent disability, property damage, or even death, deriving from, but not limited to, equipment malfunctions; building malfunctions; lack of supervision; lack of proper equipment or padding, netting, or other safety measures; slipping; falling; landing; or colliding with fixed objects or other people, as well as the negligence and/or omissions committed by Me, other guests, or any of the RELEASED PARTIES (collectively, “Risks”). Having been expressly advised of these Risks, I voluntarily assume the Risks, acknowledge that My participation in the Activities is purely voluntary, and elect to participate in the Activities despite these Risks.

 

5. I understand and acknowledge that HCAP’S does not manufacture the Equipment but purchases and/or leases the Equipment from a third-party. Therefore, I agree that HCAP’S is not liable for known or unknown items of defective or damaged Equipment that may be utilized as part of the Activities.

 

6. I represent that I am in good health, possess sound mind, and am in the proper physical condition to participate in the Activities. I represent that have not been advised by any health or medical professional against the Activities and I further represent and warrant that I am not under the influence of illegal drugs, alcohol, or any prescription drugs that may impair someone’s ability to safely participate in the Activities.

 

7. I understand and acknowledge that HCAP’s does not employ a health or medical professional on staff that is present at its facilities. I further understand and acknowledge that if I am injured, or may require medical assistance while present at a HCAP’S facility,HCAP’s reserves the right to call for emergency medical assistance at any time and any medical assistance provided by any health or medical professional will be at My own expense.

 

 (Initial)


8. I understand and agree that the RELEASED PARTIES are not liable for, will not replace, and will not reimburse me for any personal property that is missing, stolen, lost, or damaged at a HCAP’S facility, which includes, but is not limited to, personal property that is kept in a vehicle or locker.

 

 

9. I further acknowledge that HCAP’S has no control over or is in no way liable for any injury, damage, harm to Me resulting from other minors or adults engaging in the Activities or who are present at HCAP’S facility.

 

 

10. I understand and acknowledge that by executing this Agreement, I HEREBY VOLUNTARILY AND FULLY WAIVE, RELEASE, FOREVER DISCHARGE, INDEMNIFY AND HOLD HARMLESS THE RELEASED PARTIES FROM ANY AND ALL CLAIMS, DEMANDS, RIGHTS OF ACTION, OR CAUSES OF ACTION, RESPONSIBILITIES OR LIABILITIES, INCLUDING ATTORNEY’S FEES AND LEGAL COSTS, FOR ANY KIND OF PHYSICAL OR EMOTIONAL INJURIES, INCLUDING DEATH AND PERMANENT DISABILITY,OR ANY KIND OF PROPERTY DAMAGE, WHICH IN ANY WAY ARISES OUT OF OR IS IN ANY WAY CONNECTED WITH THE FOLLOWING: (1) MY PARTICIPATION IN THE ACTIVITIES AT HCAP’S FACILITY; (2) MY USE OF HCAP’S EQUIPMENT; (3) ANY ACT OR OMISSION BY ANOTHER GUEST AT HCAP’S FACILITY; OR (4) ANY ACT OR OMISSION BY ANY OF THE RELEASED PARTIES INCLUDING, BUT NOT LIMITED TO SUCH ACTS OR OMISSIONS RESULTING FROM GENERAL NEGLIGENCE, NEGLIGENT DESIGN, CONSTRUCTION, SUPERVISION, MANUFACTURING, MAINTENANCE, OR REPAIR OF THE EQUIPMENT OR FACILITY. I FURTHER UNDERSTAND, AGREE, AND ACKNOWLDGE THAT THE PROVISIONS OF THIS AGREEMENT ARE BINDING  AND  EFFECTIVE UPON ANY MINOR CHILD(REN) FOR WHOM I AM THE PARENT OR LEGAL GUARDIAN AND BY SIGNING THIS AGREEMENT ON BEHALF OF A MINOR, I WAIVING RIGHTS ON HIS/HER/THEIR BEHALF.

 

 

11. I understand and agree that the terms and conditions of Agreement will remain effective and in full force for a period of one (1) year, each and every time that I visit HCAP’S facility at 1190 North Kinzie ave Bradley,IL 60915.

 

12. I understand and agree that the laws of the state of ILLINOIS shall apply to and govern any dispute between Me and the Released Parties and that all claims, suits, or causes of action will be adjudicated in the Kankakee County, state of ILLINOIS.

 (Initial)

 

 

I HAVE HAD SUFFICENT OPPORTUNITY TO CAREFULLY READ THIS AGREEMENT, UNDERSTAND

ITS CONTENTS, AND AGREE TO BE FULLY BOUND BY ITS TERMS. If any of its provisions are held to be invalid or unenforceable by a court of competent jurisdiction, such holding shall not invalidate any of the other provisions of this Agreement, as the provisions of this Agreement are severable.

 

 

Signature and Date:  

 

Parent/Guardian Name (Print):  

 

Driver License Number 

 

Address: 

 

City: State: Zip: 

 

Email:  

 

Phone: 


 

 

 

List of Minor Child(ren) on Following Page

 

 
MINOR CHILD’S FIRST & LAST NAME
 
MINOR CHILD’S DATE OF BIRTH
  
  
  
  
  

 

 

 

 

 

 

 

 

 

 

 

 

 


I acknowledge I have read and understand this waiver and certify that all personal information is correct.
By signing this waiver, I agree that all information is complete and accurate.