<Your venue name>

2022
ACKNOWLEDGEMENT OF RISK AND RELEASE OF LIABILITY WAIVER

In consideration of my participation in the go-kart and all associated activities and events
operated by <YOUR VENUE NAME>, I hereby release <YOUR VENUE NAME>, its
members, employees, contractors, agents, successors and other entities working for or with
it from all liability, including but not limited to all liability caused by the only or partial fault of
<YOUR VENUE NAME>, loss, costs, damages, and causes of action, foreseen and
unforeseen, including but not limited to injury to the person or property and emotional and
bodily injuries, as well as death, deriving from or related to my renting and operation of a go-
kart at <YOUR VENUE NAME>

I understand that by engaging in the activities offered by <YOUR VENUE NAME> I can be
exposed to various inherent risks and dangers. I voluntarily accept and assume all inherent
risks and dangers, including the possibilities of emotional and bodily injuries, death, losses
and damages, including but not limited to property damage, resulting from my participation in
any activities offered by or connected to <YOUR VENUE NAME>. I also agree to pay
<YOUR VENUE NAME> for all damages to the property, facilities and equipment caused by
me, foreseen and unforeseen.

This release shall continue in force each time I rent and operate a go-kart at <YOUR VENUE
NAME>. This release shall be binding upon myself, my family, my representatives, agents,
assigns, successors and heirs.

By signing this acknowledgement of risk and release of liability waiver, I certify that:

A) I have read the content of this acknowledgement of risk and release of liability waiver
form, I understand it and sign it freely;
B) I am at least 18 years of age;
C) If I am under 18 years of age, my parent of legal guardian must sign this form;
D) I hold a valid state driver’s license;
E) I have not consumed alcohol or drugs;
F) I am not pregnant;
G) I will follow all rules and instructions of <YOUR VENUE NAME>;
H) I am aware I am waiving certain legal rights including the right to sue.

Full name: ______________________________

Date of birth: ___________________________

Signature:______________________________
Date:_____________

Parent/guardian signature if under 18:_______________________________

Date:_____________