Anger Mangement Rage Room Waiver Form
Please read and sign the waiver before participating in the Rage Room experience.
Participant's Full Name
First Name
Last Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
I acknowledge that I am participating in the Anger Mangement Rage Room experience at my own risk. I understand that this activity involves physical exertion and the potential for injury.
I Agree
I Do Not Agree
I hereby release and hold harmless the Anger Mangement Rage Room, its owners, employees, and agents from any and all claims, liabilities, or damages arising from my participation in this activity.
I Agree
I Do Not Agree
I confirm that I am at least 18 years of age, or if under 18, I have obtained parental consent to participate in this activity.
I Agree
I Do Not Agree
I consent to photographs and videos being taken of me during my participation in ANGER MANGEMENT RAGE ROOM, and to publication of the photographs and videos by the Releasees for advertising, promotional and marketing purposes. I consent to video monitoring throughout the building and in individual rooms. I understand that my session may be stopped at any time as a failure to comply with instructions.
I Agree
I Do Not Agree
Do you have any medical conditions or injuries that we should be aware of?
Signature of Participant
Signature of Parent/Guardian
Date
-
Month
-
Day
Year
Date
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