SMASH ROOM WAIVER

The Propel Productions Center, Inc. (PPC) mission is to “Create Change!” through creating a culture that prioritizes Social, Emotional, and Behavioral wellness by changing how we explore, understand, and address our mental health and emotional wellness needs. Remix Rage Smash Room is a program under PPC.

RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT

(Hereinafter the “Release Agreement”)

BY SIGNING THIS DOCUMENT, YOU WILL WAIVE OR GIVE UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE OR CLAIM COMPENSATION FOLLOWING AN ACCIDENT. PLEASE READ CAREFULLY!

TO: Propel Production Center, Inc. Remix Rage Smash Room and their respective directors, officers, employees, guides, agents, representatives, volunteers, independent contractors, subcontractors, sponsors, successors and assigns (of all whom hereinafter collectively referred to as the “Releasees”

DEFINITION: In this Release Agreement, the term “Sports” shall include any use or participation in the Rage/Smash Room facility and related equipment, and any other activities, events or services provided, arranged, organized, sponsored or authorized by the Releasees in any way associated or connected with the Rage/Smash Room.

ASSUMPTION OF RISKS: I am aware that the Sports involves unusual risks, dangers and hazards including, but not limited to: accidents which may occur as part of facility activities; slips and falls; malfunction of the equipment used; injury and open wounds; shock, stress or other injury to the body while participating in the Sports; negligence on the part of other persons: and NEGLIGENCE ON THE PART OF THE RELEASEES. I

UNDERSTAND THAT NEGLIGENCE INCLUDES FAILURE ON THE PART OF THE RELEASEES TO TAKE REASONABLE STEPS TO SAFEGUART OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF THE

SPORTS. I acknowledge that the Sports may result in injury, worsening of an existing medical condition, or death. I freely accept and fully assume all such risks, dangers and hazards and the possibility of injury, death, property damage or loss resulting therefrom.

MEDICAL CONDITION: I understand that the Sports may place unusual stresses on the body. The Sports are not recommended for persons suffering from asthma, epilepsy, cardio/respiratory disorder, hypertension or skeletal, joint or ligament problems or conditions, and certain mental illnesses. Women who are pregnant or suspect they are pregnant, and persons who have consumed alcohol or drugs, are not recommended to engage in the Sports. I have been advised to consult with my medical or mental health practitioner if I have any concerns about my medical or mental condition or fitness to engage in the Sports.

“Creating Change!” 240.230.7352 info@propelproductionscenter.org www.propelproductionscenter.org

RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT: In consideration of the Releases agreeing to my participation in the Sports, and permitting my use of the Sports’ equipment, room and other facilities, I hereby agree as follows:

1. TO WAIVE ANY AND ALL CLAIMS AND TO RELEASE THE RELEASEES from any and all liability for any loss, damage, expense or injury including death that I may suffer, or that my next of kin may suffer, as a result of my participation in the Sports, DUE TO ANY CAUSE WHATSOEVER, INCLUDING

NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE, INCLUDING ANY DUTY OF CARE OWED UNDER THE OCCUPIERS LIABILITY ACT, R.S.O. 1990, ON THE PART OF THE RELEASEES. IN UNDERSTAND THAT NEGLIGENCE INCLUDING THE FAILURE ON PART OF THE RELEASEES TO TAKE REASONABLE STEPS TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF THE SPORTS REFERRED TO ABOVE;

2. TO HOLD HARMLESS AND INDEMNIFY THE RELEASEES from any and all liability for any property damage or personal injury to any third party resulting from my participation in the Sports;

3. This Release Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns and representatives, in the event of my death or incapacity;

4. This Release Agreement and any rights, duties and obligations as between the parties to this Release Agreement shall be governed by and interpreted solely in accordance with the laws of the State of Maryland and not other jurisdiction;

5. Any litigation involving the parties to this Release Agreement shall be brought solely within the state of Maryland and shall be within the exclusive jurisdiction of the Courts of Maryland.

PHOTO/VIDEO RELEASE: I consent to the photographs and videos being taken of me during my participation in the Sports, and to publication of the photographs and videos by the Releasees for advertising, promotional and marketing purposes.

In entering into this Release Agreement, I am not relying on any oral or written representations or statements made by the Releasees with respect to the safety of the Sports, other than this Release Agreement.

I CONFIRM THAT I HAVE READ AND UNDERSTOOD THIS RELEASE AGREEMENT PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS RELEASE AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN EXECUTATORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASEES.

I am the age of 18 or older. (Indicate yes or no below)

Name & Signature of Parent/Guardian:

(if participant is under the age of 18)

“Creating Change!” 240.230.7352 info@propelproductionscenter.org www.propelproductionscenter.org