Complete a waiver for myself
Complete a waiver for myself and children
Viewing the video is required before you can proceed to next step.

Adult Information

( Indicates a required field )

( Age must be at least 18 years old )

Contact Information

Participants

Liability Waiver

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.

Fun Zone Depot (FZD, Under the Auspices of Buster2, LLC)

Participant Agreement, Waiver of Liability, and Assumption of Risk Agreement

 

Effective immediately upon execution, I hereby acknowledge and agree that participation in any and all activities at the Fun Zone Depot (under the auspices of Buster2, LLC., 104 N Locust Street, Pittsburg, KS 66762), including but not limited to, programs, activities, equipment, games, classes, and parties all have inherent risks. I hereby agree to release, forever discharge, and agree to indemnify and hold harmless from liability the Fun Zone Depot, its owners, directors, officers, employees, agents, volunteers, participants, successors and assigns, and their respective heirs, personal representatives, affiliates, successors and assigns, and any and all persons, firms or corporations, or entities acting for them, liable or who might be claimed to be liable, whether or not herein named, none of whom admit any liability to the undersigned (hereinafter collectively referred to as “Releasees”), but all expressly denying liability, from any and all claims, demands, damages, death, accidents, actions, causes of action or suits of any kind or nature whatsoever, which I now have or may hereafter have, arising out of or in any way relating to my participation/attendance, any and all injuries and damages of any and every kind including negligence, use of equipment or facilities - to both person and property (whether that use is supervised or unsupervised), and also any and all injuries and damages that may develop in the future on behalf of myself, my children, parents, heirs, assigns, personal representative and estate, and also agree as follows:

In addition, in consideration of being allowed to enter the Fun Zone Depot facility and/or participate in any programs, activities, games, classes, parties, or any other event or use of equipment at the Fun Zone Depot, the undersigned, on his or her own behalf and/or on behalf of the participant(s) identified below, acknowledges, appreciate and agrees to the following:

  1. I understand any and all activities at the Fun Zone Depot can be dangerous and hazardous. The activities at the Fun Zone Depot require certain degrees of skill, ability, physical condition and participant(s) must be in good health. I understand that these activities can result in serious injury, disability and/or death to the participant(s) and/or me. I assume any and all risks, damages or injuries I/we may incur while on the FZD premises. I certify that I and/or my child(ren) are in good health and that I and/or my child(ren) have no medical or physical limitations, which would preclude safe participation at the FZD or else I am willing to assume and bear the costs of - all risks that may be created, directly or indirectly, by any such condition. In addition, if I/we observe any hazard/danger during our participation, I/we will bring it to the attention of the nearest Fun Zone Depot employee and/or management immediately. I further acknowledge that for myself and participants named below, participation in activities at the Fun Zone Depot is strictly voluntary and I elect to participate despite the risks. In addition, if at any time I believe that event conditions are unsafe or that I am unable to participate due to physical or medical conditions, then I will immediately discontinue participation.
  1. I will review the Fun Zone Depot policies and operational rules and understand that it is my responsibility to ask questions about these policies and rules if necessary. I understand that it is my responsibility to ensure that I/my children understand the rules. Although there are staff to observe children/adults on the Fun Zone Depot premises, it is my responsibility to supervise my children and my own activities. The Fun Zone Depot is not an insurer or guarantor of my child(ren)’s safety and by admitting my child(ren), Fun Zone Depot does not assume the parental responsibility to supervise and direct my child(ren)’s activities. I will bring any observation of the rules being broken to the attention of a Fun Zone Depot staff member.
  1. I understand that as a parent/guardian, I may not leave the facility at any time without another adult taking full responsibility for or supervising my child(ren). I am fully aware that any child left in the facility without a parent/guardian or supervisor will be immediately turned over to the appropriate authorities. I am fully aware that all guests under the age of 16 must be accompanied by an adult at all times while visiting the Fun Zone Depot, without exception, and will not be admitted without adult accompaniment. Minor children should not be left unattended.
  1. The only exception to the above #3 is when this waiver is signed and submitted as part of a group attendance/participation such as a school field trip, where a group representative or approved school chaperone accepts supervisory responsibility.
  1. I understand that pictures and/or video of myself or my supervised child(ren) are from time to time taken at the Fun Zone Depot by employees or other patrons and could be used for promotional purposes including website visibility and social media.
  1. Should Releasees or anyone acting on their behalf be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs. 

Parent's Or Legal Guardian's Additional Indemnification (Must Be Completed For Participants Under Age Of 18)

The Minor(s), attached to this waiver, are permitted to participate in the Fun Zone Depot activities and to use its equipment and facilities, I further agree to indemnify and hold harmless the Fun Zone Depot and all other persons from any and all claims and causes of action that I, said Minor may have against said Releasee, which may be brought by or on behalf of the Minor and which are in anyway connected with such use or participation by Minor in any and all activities at the Fun Zone Depot, 104 N Locust Street, Pittsburg, KS 66762 by Minor. I further certify that I am the parent or legal guardian of the Minor(s) as listed above on this agreement.

Assumption of Risk, Indemnification of All Claims, and Covenant Not to Sue Relating to the Climbing Wall

I and/or the above listed Minor(s) are aware that participating in/on the portable rock climbing wall can be a dangerous activity involving many risks of physical and emotional injury and involves known and unanticipated risks. I have full knowledge of the nature and extent of all the risks associated with rock climbing and the use of the climbing wall including but not limited to climbing on, or falling off, loose or damaged artificial holds; falling to the ground or onto other participants, or being fallen on by other participants; abrasions from the walls, ropes, or the floor; equipment failure, auto-belay failure, rescue systems, climbing hardware, carabiners, anchor points, medical conditions resulting from physical activity or climbing out of control or beyond one’s personal limits; damaged clothing or other property; and the negligence of other climbers, visitors, participants, or other persons who may be present, or my own negligence. I understand that the dangers and risks of participating in wall climbing include, but are not limited to, death, serious neck and spinal injuries (which may result in paralysis), broken bones, torn ligaments, or bruises, and serious injury or impairment to other aspects of my body, general health, and well-being. I understand such risks cannot be eliminated, despite the use of safety equipment, without jeopardizing the essential qualities of the activity. I further acknowledge that the above list is not inclusive of all possible risks associated with the use of the climbing wall and that the above list in no way limits the extent or reach of this release and covenant not to sue. 

Assumption of Risk and Waiver of Liability Relating to Coronavirus/COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. The Fun Zone Depot has put in place preventative measures to reduce the spread of COVID-19; however, the Fun Zone Depot cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending the Fun Zone Depot could increase your risk and your child(ren)’s risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending the Fun Zone Depot and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the Fun Zone Depot may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Fun Zone Depot employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at the Fun Zone Depot or participation in any and all Fun Zone Depot programming, activities, attractions, events, or parties. On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the Fun Zone Depot, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Fun Zone Depot, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in or visit to the Fun Zone Depot.

By signing & submitting this document, I acknowledge that if any person (myself or my child/children) is injured or property is damaged during my participation in the any and all activities, I may be found to have waived my and my child’s legal right to maintain a lawsuit against the Fun Zone Depot on the basis of any claim from which I have released them herein. I acknowledge that I have carefully read this “Waiver of Liability and Assumption of Risk” and fully understand that it is a release of liability. I expressly agree to release and discharge all of its affiliates, managers, members, agents, assigns from any and all claims or action against the Fun Zone Depot for personal injury or property damage. I also hereby certify that I am over 18 years of age and voluntarily agree to all terms, conditions and responsibilities set forth in the above terms and conditions. I am aware that by signing this agreement, I am agreeing to comply with all rules and policies set forth by the Fun Zone Depot.

This release shall be binding upon the undersigned, and his respective heirs, executors, administrators, personal representatives, successors and assigns. This Release shall be subject to and governed by the laws of the State of Kansas and I agree that the substantive law of Kansas shall apply. And in the event that I file a lawsuit, I agree to do solely in the State of Kansas. I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel prior to signing. Also, I understand that this activity might not be made available to me or that the cost to engage in this activity would be significantly greater if I were to choose not to sign this release, and agree that the opportunity to participate at the stated cost in return for the execution of this release is a reasonable bargain. The terms have been explained to me and I am freely, knowingly and voluntarily entering into this Release also knowing that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.

By submitting this waiver (including electronic signature), I agree that if I am or my property damaged, then I may be found by a court of law to have waived my right to maintain a lawsuit against the Releasee on the basis of any claim for negligence. This Release has been carefully read and fully understood by the undersigned:


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.