Sign Waiver Form
Submitting Waiver



Accident Waiver and Release of Liability Form


HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH ESCAPE IN 60, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.

I certify that I understand this activity has potential risks including but not limited to:

Use of simple tools;
Potentially moving or lifting objects of not more than twenty pounds;
Mental stress and anxiety;
Magnets are in use;
Potential exposure to allergens;
Being in a reasonably small space with up to fifteen persons;
Possibility of failure to escape the room in the allotted time.

I have no physical or mental illness that precludes my participation in a safe manner for myself or others. I am not under the influence of drugs or alcohol which impairs my ability to maintain my safety awareness or endangers others.

I acknowledge that this Accident Waiver and Release of Liability Form will be used by the organizers of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity. I agree that all staff or authorized agents may, in their sole discretion, determine it is unsafe for myself or others for my participation to continue, remove me from the premises by any lawful means.

In consideration of my application and permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:

(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me, THE FOLLOWING ENTITIES OR PERSONS: The directors, officers, employees, volunteers, representatives, and agents of any and all entities authorizing this activity;

(B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise.

I acknowledge that the directors, officers, employees, volunteers, representatives, and agents of any authorizing entity are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf.

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity.

I understand while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose this authorizing entity decides, and assigns.

The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.

Please select who will be participating...

AdultAdult and Minor(s)


1 Minor 2 Minors 3 Minors 4 Minors 5 Minors + 6 Minors 7 Minors 8 Minors 9 Minors 10 Minors


First Minor's Name



First Minor's Date of Birth



Second Minor's Name



Second Minor's Date of Birth



Third Minor's Name



Third Minor's Date of Birth



Fourth Minor's Name



Fourth Minor's Date of Birth



Fifth Minor's Name



Fifth Minor's Date of Birth



Sixth Minor's Name



Sixth Minor's Date of Birth



Seventh Minor's Name



Seventh Minor's Date of Birth



Eighth Minor's Name



Eighth Minor's Date of Birth



Ninth Minor's Name



Ninth Minor's Date of Birth



Tenth Minor's Name



Tenth Minor's Date of Birth



Participant's Name



Participant's Date of Birth



Participant's Signature



Edit Signature

Parent or Guardian's Name



Parent or Guardian's Date of Birth



Parent or Guardian's Signature



Edit Signature

Email Address




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A copy of this waiver form will be emailed to the address you provided.

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