ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
Sipping Soul, Inc dba Spin Art Atlanta located at 225 Peachtree Industrial Blvd Suite 104, Sugar Hill, GA 30518
I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH THIS Spin Art EVENT, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the Sippin Soul, Inc dba Spin Art Atlanta or directors, officers, managing members, employees, volunteers, representatives, and agents of Sipping Soul, Inc dba Spin Art Atlanta 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:
1) Use of Acrylic and other types of home paints that may or may not consist of Lead based paint; 2)Potentially moving or lifting objects of not more than ten pounds; 3)Mental and physical stress and anxiety; 4)Being in a reasonably small space with strangers and other groups; 5)Possibility of failure to create spin art desired. 5) Incidents incurred by the Quick drying machine. 6) Potential dizziness due the nature of the tables.
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 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 Sipping Soul, Inc dba Spin Art Atlanta 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, ask to leave the premises.
I hereby grant permission to Sipping Soul, Inc dba Spin Art Atlanta and its representatives to take photographs or videos of me and to make recordings at the event or location 225 Peachtree Industrial Blvd Suite 104, Sugar Hill, GA
I further grant to the producers and their representatives the right to reproduce, use, exhibit, display, broadcast, distribute and create derivative works of their images and recordings in any media now known or later developed.
I acknowledge that Sipping Soul, Inc dba Spin Art Atlanta owns all rights to the images and recordings.
I hereby waive any right to inspect or approve the use of the images or recordings or of any written copy.
I further waive all moral right. I also waive any right to royalties or other compensation arising from or related to the use of the images, recordings, or materials.
I hereby release, defend, indemnify and hold harmless the producers from and against any claims, damages, or liability arising from or related to the use of the images recordings or materials, including but not limited to claims of defamation, invasion of privacy, or rights of publicity or copyright infringement, or any misuse, distortion, blurring, alteration, optical illusion or use incomposite from that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution. I am 18 years of age or older and I am competent to contract in my own name.
I have read this document before signing below, and I fully understand the content, meaning and impact of this consent, waiver, indemnity and release. This consent, waiver, indemnity and release is binding on me, my heirs, executors, administrators and assigns.
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 and clothes damage, property theft, or actions of any kind which may hereafter occur to me, THE FOLLOWING ENTITIES OR PERSONS: The directors, officers, managing members, employees, volunteers, representatives, and agents of Sipping Soul, Inc dba Spin Art Atlanta and ; insurers, and affiliated organizations
(B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE Sipping Soul, Inc dba Spin Art Atlanta or directors, officers, managing members, employees, volunteers, representatives, and agents of Sipping Soul, Inc dba Spin Art Atlanta 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, managing members, 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 including marketing.
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.
