R8, 2023-07-01

NOTE: Adirondack Axe does not accept paper waivers, please submit electronically.

Adirondack Axe LLC.- BASH IT

Release of Liability, Waiver of Claims, Expressed Assumption of Risk, and Indemnity Agreement

Please read carefully and be certain you understand the implications of signing.

1. I fully understand and acknowledge the inherent risks associated with the activity of smash rooms; the potentially dangerous nature such as flying debris, slipping, falling, collision with fixed objects, strains, sprains, broken bones, cut, cardiac arrest, hearing loss, emotional injury, negligence of participates not adhering to safety rules, equipment failure and the physical exertion associated with this activity. The potentially dangerous environment that can be caused to myself, and/or to others, from the meant purpose of this activity. I also understand that any equipment provide to me does not remove any risk and is not guaranteed to protect me at all times. Closed toes shoes are required and long sleeve shirts and pants are highly recommended as the basic coveralls issued help against small particles and debris only.

2. I acknowledge and understand that I will be voluntarily engaging in smash room activities, which may result in the risk of serious injury, scarring, loss of an important bodily function, permanent disability, or death, and may cause severe social or economic losses due to not only my own actions, inaction or negligence, but also to the action, inaction or negligence of others, or conditions of the premises or of any equipment used. Further, I acknowledge that there may be other risks not known to me or not reasonably foreseeable at this time.

3. I believe that I am physically, emotionally and mentally able to participate in a smash room activity.

4. I will immediately remove myself from participation and notify the nearest staff member if at any time I sense or observe any unusual hazard or unsafe condition, or if I feel that I have experienced any deterioration in my physical, emotional or mental fitness for continued participation.

5. I assume all the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability, or death.

6. I release from, waive and discharge all actions, claims, or demands that I, my assignees, heirs, guardians, and legal representatives now have or hereafter have for damage or losses on account of injury, including permanent disability and death or damage to property, caused or alleged to be caused in whole or in part by the negligence or other acts of Adirondack Axe, LLC, its subsidiaries, shareholders, directors, officers, employees or agents, as a result of my participation in smash room. I hereby agree and covenant to save and hold harmless, indemnify, and defend any claim against Adirondack Axe, LLC, its subsidiaries, and its shareholders, directors, officers, employees or agents, as a result of my participation in any smash room related activities.

7. I agree that neither myself, nor my assignees, heirs, guardians, and/or legal representatives will sue Adirondack Axe, LLC, its subsidiaries, shareholders, directors, officers, employees or agents as a result of my participation in any smash room activities.

8. I agree to exercise ordinary and reasonable care at all times. I will not be impaired by the use of drugs and/or alcohol on any Adirondack Axe, LLC premises. I acknowledge and agree that Adirondack Axe, LLC shall not be responsible or liable for any accident, injury, theft, loss, or damage caused by my impaired judgment or negligence.

9. I agree and understand that the staff and/or owners of Adirondack Axe, LLC reserve the right to refuse entry, suspend or cancel smash room related activities at any time for any reason.

10. I hereby grant permission to the rights of my image, likeness and sound of my voice as recorded on audio or videotape without payment or any other consideration. I understand that my image may be videotaped, edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording.

11. Further, I agree that by signing this waiver I will forgo using any personal photographs, pictures, videos, or other recorded media taken in, on or around any Adirondack Axe, LLC premises for any unlawful use that would directly, or indirectly, infringe upon Adirondack Axe, LLC proprietary rights. Specifically, but not limited to, using any recorded media such as, but not limited to, photographs, videos, or voice recordings, for any personal or professional monetary gain, for any personal or professional promotional uses, for any advertising purposes, or for any other type of use that would cause public confusion as to the proprietary ownerships of Adirondack Axe, LLC business operations.

13. SEVERABILITY. The undersigned expressly agrees that the foregoing assumption of risk, release and waiver of liability and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the State of New York and that if any portion thereof is held invalid, it is agreed that the remainder of the agreement, shall, notwithstanding, continue in full legal force and effect.

14. BINDING ARBITRATION. I agree that any dispute relating to, referring to, involving or pursuant to this Agreement of release of liability, waiver, assumption of risk and indemnity shall be resolved exclusively by binding arbitration according to the rules of the American Arbitration Association. Such proceedings will be governed by substantive law of the State of New York, excluding any application or consideration of the Arbitration Act of said State.

By entering into this agreement, I am not relying on any oral or written representations or statements made by Adirondack Axe, LLC other than what is set forth in this agreement. DO NOT under any circumstances sign this waiver if you do not feel you can fully, competently, emotionally and mentally adhere to each and every article above.

I HAVE CAREFULLY READ THE ABOVE WAIVER AND RELEASE OF LIABILITY AND FULLY UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT AND I DO SIGN IT VOLUNTARILY. I AGREE TO PARTICIPATE KNOWING THE RISKS AND CONDITIONS INVOLVED AND DO SO ENTIRELY OF MY OWN FREE WILL. I ACKNOWLEDGE READING THE RULES AND REGULATIONS OF THE SMASH ROOM FACILITY AND AGREE TO ABIDE BY THEM.

We should not be held responsible for any injury or personal loss that may occur during the signing of this waiver.

Please select who will be participating:

First Minor's Information


Second Minor's Information


Third Minor's Information


Fourth Minor's Information


Fifth Minor's Information


Sixth Minor's Information



Please enter your legal name as it appears on your government issued ID.

By checking here, you acknowledge you have read and understand the above terms, and 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. By checking here, 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.