FIREWALK LIABILITY RELEASE FORM

This is a legally binding liability release, waiver, discharge and covenant not to sue Firewalk Productions, LLC, Firewalk Adventures or Town of West Jefferson, NC & Boondocks Brew Haus and any and all shareholders, officers and directors of any and all sponsoring entities.

I, _______________________________________, fully recognize that there are dangers and risk to which I can be exposed by firewalking, and I understand that my participation in this firewalking event/seminar is completely voluntary and at my own risk. I also understand that no assurance guaranteeing my safety is being made, and I agree to hold all the entities mentioned above and any and all shareholders, officers and directors completely harmless of all liability if I sustain any injuries during my participation in this firewalking event/seminar.

By signing this release form, I am waiving all rights to compensation in case of injury. I also attest that I am over 18 years of age (or otherwise have parental consent), and I agree to assume full responsibility of any injury / injuries – physical, mental or otherwise – that I may sustain by participating in this firewalking event/seminar.

By signing this release form, I acknowledge that I have been fully informed that: 1) people have been seriously injured by participating in firewaking seminars; 2) there is an inherent risk in firewalking; 3) if I voluntarily choose to firewalk, there is a possibility I may receive injuries requiring medical attention.

I agree not to bring any suit for damages regardless of whether or not negligence can be demonstrated, and I release all parties associated with this firewalk event/seminar from the responsibility for any damages suffered by me whether physical, mental or financial.

I understand fully that I am solely responsible for all my choices during the event/seminar and that I have the right to refuse participation at any time during the event/seminar. I have been fully informed regarding the usage of drugs and /or alcohol consumption and been told that using drugs and /or consuming alcohol before this event/seminar is dangerous, highly discouraged and must be postponed until after the event/seminar.

I certify that I have no physical conditions which inhibit healing, such as diabetes, auto-immune diseases, or any other medical condition(s). that might adversely affect my physical and/or mental well being in the event of injury. I further affirm that I do not desire to inflict harm upon myself.

By signing this form, I release any and all claim(s) for any and all injuries and/or claim(s) I may have while attending this firealking event/seminar. I am knowingly and voluntarily assuming any and all risk(s) of injury.

My signature below specifies that I have included death, and I am knowingly and voluntarily signing this release form, read and fully understand everything contained in this waiver and assumption of Risk Form. I have read this entire Release Form, I fully understand the contents of this Form, and I agree to be legally bound by this Release Form.

THIS SIGNED FORM IS A RELEASE OF YOUR RIGHTS. DO NOT SIGN UNLESS YOU AGREE.
READ CAREFULLY BEFORE SIGNING.

ASSUMPTION OF RISK, WAIVER, DISCHARGE AND COVENANT NOT TO SUE