Insomnia Escape Room Waiver

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH THIS INSOMNIA ESCAPE ROOM EVENT, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.

I certify that I understand this activity has potential risks including but not limited to:

1) Use of simple tools;
2) Potentially moving or lifting objects of not more than ten pounds;
3) Mental stress and anxiety;
4) Being in a reasonably small space with up to 10 people;
5) The possibility of failure to escape the room in the allotted time.

I have no physical or mental illness that precludes my participation in a safe manner for myself or others. I am not under the influence of drugs or alcohol which impairs my ability to maintain my safety awareness or endangers others. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the organizers of the activity in which I may participate and that it will govern my actions and responsibilities at said activity. I agree that all staff or authorized agents may, in their sole discretion, determine it is unsafe for myself or others for my participation to continue, remove me from the premises by any lawful means. In consideration of my application and permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:

(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me, THE FOLLOWING ENTITIES OR PERSONS: The directors, owners, officers, employees, volunteers, representatives, and agents of any and all entities authorizing this activity;
(B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise.

I acknowledge that the directors, owners, officers, employees, volunteers, representatives, and agents of any 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.

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. 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 agree not to make video or photos unless the Game Master permits it. I agree not to publish details of the activity on media, social media, Internet, etc. to keep the fun for everyone (No spoilers policy).

I agree to pay for the items I brake within the room.
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Adult Participant or Legal Guardian of Minors Name *
This is a field for the adult participant full legal name (FIRST and LAST names). Names of participating minors will go in the next field
Names of Participating Minors (if any)
Please type in all FIRST and LAST names of participating minors (under 18 years old) separated by SPACE
Signature *
Player/Parent/Guardian Signature ** If a participant is a minor under 18, I certify that I am the parent or legal guardian of the above minor and confirm that the information I entered is accurate and true. I am at least 18 years old and I have read and agree to the terms of the above agreement. By typing my INITIALS below, I am electronically certifying this waiver document just as if I would have physically signed it if it was on paper.
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