***REQUIRED or NO SMASHING***

Welcome to WreckIt Rage Room!

To keep things safe and fun, all participants must complete this short waiver before entering the rage room.

✅ Thanks for your payment! Before we can start the session, this short form must be completed to confirm you understand the safety rules and emergency procedures.

1. Contact Information

First Name

Last Name

Email *

Phone *

Appointment Date *

2. 📞 Emergency Contact

Who should we call if there’s an emergency during the session?

Emergency Contact Name *

Emergency Contact Phone *

✅ Emergency Medical Consent (Checkboxes): *

I authorize WreckIt Rage Room staff to arrange for emergency medical care if needed and accept responsibility for any related costs.

I understand that WreckIt Rage Room staff may act in my best interest in the event I cannot be reached during an emergency.

Please check both boxes to give emergency medical consent.

3. ✅ Agreement

I agree to the Terms of Service and Privacy Policy, and I understand how my booking, cancellations, and personal information are handled.

(This must be agreed to before proceeding)

4. ⚠️ Assumption of Risk, safety, and Liability Waiver

(Please check each box to confirm your understanding and agreement. Required to participate.) *

I understand participation involves physical activity and risk of injury.

I accept full responsibility for my safety and actions.

I release WreckIt Rage Room and staff from any liability for injuries or damages.

I will ensure safety rules are followed and protective gear is worn.

I understand anyone under the influence of drugs or alcohol cannot participate.

I understand the experience may be loud, chaotic, and emotionally intense.

I will only smash items in designated zones, using safe methods.

I acknowledge that surveillance cameras may be in use for safety and liability purposes.

I certify that I am not under the influence of alcohol/drugs and have no medical condition (including but not limited to COVID-19) that prevents safe participation.

I understand there are no refunds, and rescheduling may require an additional fee.

I agree that photos/videos of me may be taken and used for promotional purposes.

5. ✍️ Signature

I confirm that I am at least 18 years old and legally responsible for myself. I accept all terms listed above. *

Clear

Waiver Signed At