Lazerland of LI Participant Waiver


Participant’s Name ___________________________________________________


Parent’s/Guardian’s Name       ____________________________________________


1.      The participant wishes to participate in:

                              ___ Laser Tag    ___ Dodgeball    ___ Bouncey Fun Express Train Station    ___Junior Sports


2.         As a participant, I:

          A.        Acknowledge that participation in the activities selected above involves physical activity and/or the use of equipment apparatus and facilities that  could result in injury to the participant. The participant assumes full responsibility for any injuries or damages which may occur to or be caused by the participant in, on, or about Lazerland of LI’s premises or as a result of participation in any of the activities at Lazerland of LI, from whatever cause, including, without limitation, the negligence of Lazerland of LI, its owners, employees, agents, customers, invitees or visitors, and releases, discharges, and agrees to indemnify and hold harmless Lazerland of LI, its owners, employees, and agents from and against all loss, liability and expense present or future, whether or not known or anticipated, arising out of or resulting from, directly or indirectly, the participant’s presence at Lazerland of LI’s premises, use or intended use of or participation in any of the games featured, offered or conducted at Lazerland of LI, use or intended use of Lazerland of LI’s premises, facilities, and/or use or intended use or any equipment or apparatus related thereto. The undersigned has read and understands the foregoing waiver. The undersigned acknowledges that if he/she is under 21 years of age, he/she has discussed the terms and conditions of this waiver with his/her parents or legal guardians and has each such parent’s or legal guardian’s consent to his/her signing this waiver and to the provisions, agreements, terms and conditions of this waiver.

          B.        Agree to play the activities according to the rules and instructions given to me by any members of Lazerland of LI’s staff. I acknowledge that Lazerland of LI accepts no responsibility for any act or anything done by me which is not in accordance with the rules and instructions of Lazerland of LI.

          C.       Accept full responsibility for any damage to the Lazerland of LI premises, facilities, and/or equipment caused by me.

          D.       Agree to inform a member of the Lazerland of LI staff of any medical condition or treatment that I have, prior to participating in any activity at Lazerland of LI.

                           E.	                  The participant (s) are 6 years of age or older    

Signature of participant (Or parent or legal guardian):__________________ Date Signed: ___________________


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