Dirty Biker Design - Dancing Pole Participation Waiver & Release of Liability
Participant Name:
First Name
Last Name
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Format: (000) 000-0000.
Date:
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
I voluntarily choose to use the dancing pole provided by Dirty Biker Design. In consideration for being allowed to participate, I acknowledge and agree to the following:
1. Assumption of Risk
I understand that using a dancing pole involves inherent risks, including but not limited to slips, falls, strains, sprains, fractures, head injuries, bruises, paralysis, and other serious injuries or death. I voluntarily accept all risks associated with participation.
2. Physical Condition
I certify that I am physically capable of participating and have no medical condition that would make participation unsafe. I understand that I should not participate if I am under the influence of alcohol, drugs, or any substance that may impair my judgment, coordination, or balance.
3. Rules
I agree to:
Use the pole only as intended.
Follow all instructions given by Dirty Biker Design staff.
Stop immediately if instructed to do so.
Not attempt dangerous tricks, inversions, aerial moves, flips, climbing to excessive heights, or any maneuver beyond my ability.
Wear appropriate footwear or participate barefoot if instructed.
4. Release of Liability
To the fullest extent permitted by law, I release and hold harmless Dirty Biker Design, its owners, employees, volunteers, affiliates, event organizers, property owners, sponsors, and representatives from any and all claims, demands, damages, losses, liabilities, costs, or expenses arising from or related to my participation, including injuries resulting from ordinary negligence.
5. Responsibility for Damage
I agree to be responsible for any intentional or reckless damage I cause to the equipment.
6. Photography
I understand that photographs or video may be taken during the event. Unless I notify Dirty Biker Design in writing before participating, I grant permission for my likeness to be used for promotional purposes without compensation.
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