Axe throwing disclaimer
Date of activity
DD slash MM slash YYYY
Time of activity
Name of which the booking is booked under?
Date of Birth (required for anyone under 16 years)
DD slash MM slash YYYY
Emergency Contact - Contact name and relationship
Terms and Conditions
I UNDERSTAND THAT: 1. That Axe Throwing is a dangerous activity if not played correctly. 2. The possibility of injury to others and myself exists. 3. Only one person to play at a time. I CONFRIM AND AGREE THAT: 1. I am fully aware of the risks to myself and others involved in Axe Throwing. 2. I am in good health and physically fit and have good eye sight 3. I am physically and mentally able to take the strain and exertion involved in the game. 4. The person filling out this form is 16yrs or over. 5. That i am not under the influence of alcohol, drugs or any other substances, legal or otherwise. 6. I accept that i will be responsible for any decision as to my fitness to participate in this activity 7. I agree that Keypitts Off Road Adventures Ltd. reserves the right to terminate my participation of the activity at any time if they consider my actions to be dangerous, negligent or detrimental to my health and safety or any other participants. 8. I will comply with all Axe Throwing rules and use the equipment as instructed and not so as to injure or hurt others and obey all the directions of the game marshals. I agree that Keypitts Off Road Adventures Ltd. cannot be held responsible for any accidents caused by my acting in a negligent manner, and that in the event of an accident so caused or contributed to my acting negligently, I waive my right to take legal action against Keypitts Off Road Adventures Ltd. and may be liable to legal action by Keypitts Off Road Adventures Ltd. RELEASE: I hereby release Keypitts Off Road Adventures Ltd. the owners of the property on which the game is being played and any other player in the game who might injure me, howsoever arising, from any claims or liabilities without limitation. I make this release on behalf of heirs, my executors, administrators and myself. I understand that failure to abide by the rules and regulations could cause death or injury. I hereby declare that I have read and agree to abide by the above-mentioned conditions, rules and regulations. (Parent or Guardian to sign for anyone under 16 years of age) RIDERS UNDER THE AGE OF 16yrs: Parent/Guardian accepts full responsibility for the child named above and confirms I have read the above to him/her and accepts the child rides at his/her own risk.
Signature: Please type you name in full to declare that you have read and agree to abide by the above-mentioned conditions, rules and regulations.
If signing on behalf of rider please state relationship to the rider:
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