7/27/2019 BBM Signature Parental Consent Form.pdf

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BENNY’SBARMITZVAH

JDRACINGINDOORKARTINGPARENTALCONSENT,RELEASEANDWAIVEROFLIABILITY,ASSUMPTIONOF

RISKANDINDEMNITYAGREEMENT

IN CONSIDERATION of my minor child (“the Minor”) being permitted by JD Racing Indoor Karting, LLC to participate in any way in

ACTIVITIES and/orbeingpermittedto enter forany purposeany RESTRICTEDAREA(S) (defined tobe anyareawhich requires special

authorization,credentialsorpermissiontoenteroranyareatowhichadmissionbythegeneralpublicisrestrictedorprohibited),Iagree:

1.  IknowthenatureoftheACTIVITIESandtheMinor’sexperienceandcapabilities,andbelievetheMinortobequalifiedtoparticipate

intheACTIVITIES.Iwillinspectthepremises,facilities,andequipmenttobeused,orwithwhichtheMinormaycomeincontact.IFIORTHEMINORBELIEVEANYTHINGISUNSAFE,IWILLINSTRUCTTHEMINORTOIMMEDIATELYLEAVETHERESTRICTEDAREA

ANDREFUSETOPARTICIPATEFURTHERINTHEACTIVITIES.

2.  I FULLY UNDERSTAND and will instruct theMinor that (a) THEACTIVITIES ARE VERY DANGEROUS and participation in the

ACTIVITIES and/or entry into Restricted Areas involves RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING

PERMANENTDISABILITY, PARALYSISANDDEATH (“RISKS”); (b) these Risks and dangers maybe causedby theMinor’s own

actions,orinactions,theactionsorinactionsofothersparticipatingintheACTIVITIES,therulesoftheACTIVITIES,theconditions

andlayoutofthepremisesandequipment,and/orTHENEGLIGENCEOFTHE“RELEASEES”NAMED;(c)theremaybeOTHERRISKS

NOTKNOWNTOMEorthatarenotreadilyforeseeableatthistime;(d)THESOCIALANDECONOMICLOSSESand/ordamagesthat

couldresultfromthoseRisk(s)COULDBESEVEREANDCOULDPERMANENTLYCHANGETHEMINOR’SFUTURE.

3.  IconsenttotheMinor’sparticipationintheACTIVITIESand/orentryintorestrictedareasandHEREBYACCEPTANDASSUMEALL

SUCH RISKS, KNOWN AND UNKNOWN, AND ASSUME ALL RESPONSIBILITY FOR THE LOSSES, COSTS AND/OR DAMAGES

FOLLOWINGSUCHINJURY,DISABILITY,PARALYSISORDEATH,EVENIFCAUSED,INWHOLEORINPART,BYTHENEGLIGENCEOF

THE“RELEASEES”NAMED.

4.  I HEREBY RELEASE, DISCHARGE AND COVENANT NOT TO SUE the promoters, participants, racing associations, sanctioning

organizationsoranysubdivisionthereof,trackoperators,trackowners,officials,kartowners,drivers,pitcrews,rescuepersonnel,any persons in anyRestricted Area, sponsors, advertisers, owners and leassees of premises used to conduct the ACTIVITIES,

premises or activity inspectors, surveyors, underwriters, consultants and other personsor entities whogive recommendations,

directionsorinstructionsorengageinriskevaluationorlosscontrolactivitiesregardingthepremisesorACTIVITIESandeachof

them,theirdirectors,officers,agents,employees,representatives,owners,members,affiliates,successorsandassigns,allforthe

purposeshereinreferredtoas“Releasees,”FROMALLLIABILITYTOME,THEMINOR,myandtheminor’spersonalrepresentatives,

assigns,heirs,andnextofkin,FORANYANDALLCLAIMS,DEMANDS,LOSSES,ORDAMAGESONACCOUNTOFANYINJURYTOME

ORTHEMINOR,including,butnotlimitedto,deathordamagetoproperty,CAUSEDORALLEGEDTOBECAUSED,INWHOLEORIN

PART,BYTHENEGLIGENCEFORTHE“RELEASEES”OROTHERWISE.

5.  If,despitethisrelease,I,theMinor,oranyoneontheMinor’sbehalf,makesaclaimagainstanyofthe“Releasees”namedabove,I

AGREE TODEFEND, INDEMNIFYANDSAVEAND HOLD HARMLESS THERELEASEESand each of them from ANY LITIGATIONEXPENSES,ATTORNEYFEES,LOSS,LIABILITY,DAMAGE,ORCOSTTHEYMAYINCURDUETOTHECLAIMMADEAGAINSTANYOF

THE“RELEASEES”NAMEDABOVE,WHETHERTHECLAIMISBASEDONTHENEGLIGENCEOFTHERELEASEESOROTHERWISE.

6.  IauthorizeJDRacingIndoorKarting,LLCtousephotos,andorotherlikenessesofmyselfandormychildorthechildforwhomI

havelegalguardianshipforanypromotionalmaterialsregardingJDRacingIndoorKarting,LLCprograms,facilities,orservices.Such

likenesseswillnotbesoldtootherparties.Promotionalmaterialsbearingtheselikenessesmaybedistributedforfreetothepublic

andpostedontheJDRacingIndoorKarting,LLCwebsite.JDRacingIndoorKarting,LLCreservestherighttouseanyphotoor

likeness fora time periodbeginningwhen this form is signedand ending upon writtenrequestof participant, parent or legal

guardian.

7.  IsignthisagreementonmyownbehalfandonbehalfoftheMinor.

IHAVEREADTHISPARENTALCONSENT,RELEASEANDWAIVEROFLIABILITY,ASSUMPTIONOFRISK,ANDINDEMNITYAGREEMENT,

UNDERSTANDTHATBYSIGNINGITIGIVEUPSUBSTANTIALRIGHTSIAND/ORTHEMINORWOULDOTHERWISEHAVETORECOVER

DAMAGESFORLOSSESOCCASIONEDBYTHERELEASEES’FAULT,ANDSIGNITVOLUNTARILYANDWITHOUTINDUCEMENT.

_______________________________________________________________ _________________________________SIGNATUREOFPARENTORGUARDIAN PRINTEDNAMEOFPARENTORGUARDIAN DATE

_______________________________________________________________ _________________________________SIGNATUREOFWITNESSPRINTEDNAMEOFWITNESS NAMEandAGEOFMINORPARTICIPANT