Standard Waiver Form

In consideration of renting and operating a go-kart at TBC Indoor Racing, I hereby release TBC, LLC, its members, agents, employees, landlord, successors or assigns, from any and all liability, claims demands, actions, and causes of action whatsoever, whether foreseen or unforeseen, arising out of or related in any way to my renting and operating a go-kart at TBC Indoor Racing that may result in injury, death or property damage or loss or other damages to me or my family, estate, heirs, or assigns, and further to save and hold harmless TBC, LLC, its members, agents, employees, landlord, successors or assigns, from all liability whatsoever for personal injury, property damage or loss or wrongful death caused by its negligence.
 
I understand that this activity is dangerous and may become more hazardous or dangerous during the time I am on the premises of TBC Indoor Racing, that the risk of injury from the operation of a go-kart is significant, including the potential for serious bodily injury, paralysis and death; that I am aware of all the risks and hazards inherent with my operating a go-kart at TBC Indoor Racing and hereby voluntarily assume all risk of loss, damage and injury, including death, that may be sustained by me or any property of mine while at TBC Indoor Racing.
 
This release shall be binding upon my family, estate, heirs, or assigns. This release shall continue in effect each time I rent and operate a go-kart at TBC Indoor Racing.  TBC may utilize photographic, video or other images of myself for subsequent advertising and promotion purposes without any fee or consideration to myself.
 
In signing the foregoing Liability Release, I acknowledge and represent:
 
(a) That I have read the foregoing Liability Release, understand it, and sign it voluntarily;
(b) That I am 62 inches tall for the karts;
(c) That I am not pregnant;
(d) That I have not consumed alcohol or drugs, which may affect my ability to drive a go-kart in a safe manner;
(e) That I do not suffer from a heart condition, high blood pressure or other medical condition which may be aggravated by my operating a go-kart;
(f) That I will wear a helmet while operating a go-kart or otherwise while in or around the racetrack;
(g) That I will stay seated in the go-kart with the safety belt fastened until instructed by a track official to remove the safety belt and get out of the go-kart;
(h) That I will obey all rules and regulations of TBC Indoor Racing;
(i) That I will closely observe and follow the instructions of all facility personnel;
(j) That this agreement is continuing and shall remain in effect every time I use this facility.
(k) That if I am under 18 without a driver’s license I must have my parent or legal guardian sign this form.

PLEASE PRINT

Today's Date: _____________________________ E-mail Address: ____________________________________

 How did you find out about us?  TV ___ Radio ___ Newspaper ___ Coupon ___ Friend/Colleague ___ Other ___

If other, please describe: ______________________________________________________________________

First Name: ______________________________ Last Name: ________________________________________

Date of Birth: _____________________________ Gender: ___________________________________________

Address: __________________________________________________________________________________
 
City: ____________________ State: __________ Zip Code: __________

Signature: ________________________________ Parent’s Signature: (If under 18) ______________________

Would this be something you would like to have your employer do as an employee event?  ____ Yes ____ No

If yes, please give us your company’s name ______________________________________________________

Who should we contact? _________________________________    Phone # ___________________________