app.waiverelectronic.com
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URL:
https://app.waiverelectronic.com/render/waiver/650241d3e64120d5b515b2a5
Submission: On September 15 via manual from IN — Scanned from NL
Submission: On September 15 via manual from IN — Scanned from NL
Form analysis 1 forms found in the DOM
Name: myForm —
<form name="myForm" novalidate="" class="template ng-pristine ng-valid">
<div id="testtt">
<div class="signedDate ng-binding">Signed Date: Sep 14, 2023 1:12:19 AM</div><!-- ngIf: waiver.clientIP -->
<div class="signedDate ng-binding ng-scope" style="margin-top: 3px;" ng-if="waiver.clientIP">IP Address: 99.26.183.141</div><!-- end ngIf: waiver.clientIP -->
<p style="text-align:center"> </p><!-- ngIf: waiver.expirationDate && waiver.expirationDate <= currentTimeStamp -->
<div class="headerInfo" style="overflow: hidden">
<div class="headerBox"><!-- ngIf: !(waiver.Header.logoPosition == 'right') && waiver.Header.logoImage --><span class="headerLogo ng-scope" ng-style="logoStyle" ng-if="!(waiver.Header.logoPosition == 'right') && waiver.Header.logoImage"
style="width: 20%;"><img style="width:100%" ng-src="https://waiverphoto.s3.amazonaws.com/files/QLNpe6-TEELINE_Curling_Orig.Logo_Nash (2).jpg"
src="https://waiverphoto.s3.amazonaws.com/files/QLNpe6-TEELINE_Curling_Orig.Logo_Nash (2).jpg"></span><!-- end ngIf: !(waiver.Header.logoPosition == 'right') && waiver.Header.logoImage -->
<h4 ng-hide="true" class="header ng-binding ng-hide" style="text-align: center">NEW Tee Line Curling and Bowling Waiver (USE THIS ONE)</h4>
<p ng-bind-html="trustAsHtml(waiver.Header.text)" style="padding-top: 30px; width: 100%; float: right;" ng-style="headerStyle" class="ng-binding"></p>
<p>Tee Line Curling and Bowling Waiver </p>
<p></p>
<p></p><!-- ngIf: waiver.Header.logoPosition == 'right' && waiver.Header.logoImage -->
</div><!-- ngIf: groupFixedHeader -->
</div><br><!-- ngRepeat: t in waiver.Basics -->
<div class="additionals"><!-- ngRepeat: t in waiver.Additionals -->
<div ng-repeat="t in waiver.Additionals" class="ng-scope" style=""><!-- ngIf: t.type === 'textBox' && !t.hideField -->
<div class="additional text-field ng-scope" ng-if="t.type === 'textBox' && !t.hideField" ng-hide="!waiver.showMinorTemplate && t.minorsOnly && (waiver.Settings.minor.enable == 'true')">
<div class="form-group row" style="margin: 0">
<p ng-bind-html="trustAsHtml(t.model)" class="breakWord ng-binding" ng-class="{'textBoxReadMore': t.readMore && !t.showReadMore}" id="textBox0"></p>
<p><br><br><!--StartFragment--></p>
<p style="font-size: medium;">I, (the “Participant”), desire to participate in curling and/or bowling activity provided by Tee Line, LLC, a Tennessee limited liability company (“Tee Line”).</p>
<p style="font-size: medium;">In consideration of Tee Line furnishing services and/or equipment to enable me to participate in the above mentioned activities, I agree as follows:</p>
<p style="font-size: medium;">I fully understand and acknowledge that: (a) the sport of curling and/or bowling requires physical fitness; (b) the sport of curling is played on ice; (c) curling and bowling have inherent risks, dangers and
hazards, and such exist in my use of curling and/or bowling equipment and my participation in the above-mentioned activities and undertakings; (d) my participation in such activities, including any activity involving new and/or
experimental techniques, and/or use of such equipment may result in injury or illness including, but not limited to bodily injury, disease, infectious disease, strains, fractures, partial and/or total paralysis, death or other ailments
that could cause serious disability; (e) these risks and dangers may be caused by the negligence of Tee Line, or its trainers, members, directors, agents, employees or independent contractors, the negligence of me and/or other
participants, the negligence of others, accidents, breaches of contract, or other causes; (f) the use of alcohol or any other intoxicating substance increases the risk of injury and Tee Line reserves the right to ask me to leave the
premises if I am under the influence of any intoxicating substance; (g) risks and dangers may arise from foreseeable or unforeseeable causes including without limitation a trainer’s choice of technique or instruction; and (h) by my
participation in these activities and/or use of curling and/or bowling equipment, I hereby assume all risks and dangers and all responsibility for any and all losses and/or damages, whether caused in whole or in part by the negligence
or other conduct of Tee Line, and its trainers, members, directors, agents or independent contractors, or by any other person.</p>
<p style="font-size: medium;">I, on behalf of myself, my personal representatives and my heirs, or as a parent or legal guardian of the undersigned Participant (if he or she is under 18 years of age), hereby voluntarily agree to release,
waive, discharge, hold harmless, defend and indemnify Tee Line, and its trainers, members, directors, agents, employees and independent contractors, from any and all claims, actions, or losses for bodily injury, illness, property
damage, wrongful death, loss of services or otherwise which arise out of my use of curling and/or bowling equipment or my participation in curling and bowling activities. I specifically understand that I am releasing, discharging, and
waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct by Tee Line, and its trainers, members, directors, agents, employees and independent contractors. I further agree that if
any legal action is brought, it must be in the state courts sitting in Davidson County, Tennessee, or in the United States District Court for the Middle District of Tennessee.</p>
<p style="font-size: medium;"><span style="color: #242424; font-family: arial, helvetica, sans-serif; font-size: 16px; background-color: #ffffff;">By entering Tee Line, you accept and acknowledge that your image may be used on social
media or other promotional materials.</span></p>
<p style="font-size: medium;">I HAVE READ THE ABOVE WAIVER AND RELEASE AND BY SIGNING IT, AGREE IT IS MY INTENTION TO EXEMPT AND RELIEVE TEE LINE, LLC FROM LIABILITY FOR PERSONAL INJURY, ILLNESS, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED
BY NEGLIGENCE OR ANY OTHER CAUSE.</p>
<!--EndFragment-->
<p> </p>
<p> </p>
<p> </p>
<p></p><!-- ngIf: t.readMore -->
</div>
</div>
<!-- end ngIf: t.type === 'textBox' && !t.hideField --><!-- ngIf: t.type === 'checkBox' && !t.hideField --><!-- ngIf: t.type === 'initial' && !t.hideField --><!-- ngIf: t.type === 'multiple' && !t.hideField --><!-- ngIf: t.type === 'shortAns' && !t.hideField --><!-- ngIf: t.type === 'date' && !t.hideField --><!-- ngIf: t.type === 'address' && !t.hideField --><!-- ngIf: t.type === 'name' && !t.hideField --><!-- ngIf: t.type === 'newName' && !t.hideField --><!-- ngIf: t.type === 'phone' && !t.hideField --><!-- ngIf: t.type === 'email' && !t.hideField --><!-- ngIf: t.type === 'dob' && !t.hideField --><!-- ngIf: t.type === 'gender' && !t.hideField --><!-- ngIf: t.type === 'country' && !t.hideField --><!-- ngIf: t.type === 'video' && !t.hideField --><!-- ngIf: t.type === 'takePic' && t.value && !t.hideField --><!-- ngIf: t.type === 'upLocalImg' && t.value && !t.hideField --><!-- ngIf: t.type === 'image' && t.value && !t.hideField --><!-- ngIf: t.type === 'photoOrFile' && t.value && !t.hideField --><!-- ngIf: t.type === 'signature' && !t.hideField --><!-- ngIf: t.type === 'number' && !t.hideField --><!-- ngIf: t.type === 'stripe' && !t.hideField -->
</div><!-- end ngRepeat: t in waiver.Additionals -->
<div ng-repeat="t in waiver.Additionals" class="ng-scope">
<!-- ngIf: t.type === 'textBox' && !t.hideField --><!-- ngIf: t.type === 'checkBox' && !t.hideField --><!-- ngIf: t.type === 'initial' && !t.hideField --><!-- ngIf: t.type === 'multiple' && !t.hideField --><!-- ngIf: t.type === 'shortAns' && !t.hideField --><!-- ngIf: t.type === 'date' && !t.hideField --><!-- ngIf: t.type === 'address' && !t.hideField --><!-- ngIf: t.type === 'name' && !t.hideField -->
<div ng-if="t.type === 'name' && !t.hideField" class="form-group ng-scope" ng-hide="!waiver.showMinorTemplate && t.minorsOnly && (waiver.Settings.minor.enable == 'true')"><span><strong class="ng-binding">First and last
name: <span class="requiredRed" ng-hide="t.optional == true">*</span></strong></span>
<div class="ng-binding">John Lee</div>
</div>
<!-- end ngIf: t.type === 'name' && !t.hideField --><!-- ngIf: t.type === 'newName' && !t.hideField --><!-- ngIf: t.type === 'phone' && !t.hideField --><!-- ngIf: t.type === 'email' && !t.hideField --><!-- ngIf: t.type === 'dob' && !t.hideField --><!-- ngIf: t.type === 'gender' && !t.hideField --><!-- ngIf: t.type === 'country' && !t.hideField --><!-- ngIf: t.type === 'video' && !t.hideField --><!-- ngIf: t.type === 'takePic' && t.value && !t.hideField --><!-- ngIf: t.type === 'upLocalImg' && t.value && !t.hideField --><!-- ngIf: t.type === 'image' && t.value && !t.hideField --><!-- ngIf: t.type === 'photoOrFile' && t.value && !t.hideField --><!-- ngIf: t.type === 'signature' && !t.hideField --><!-- ngIf: t.type === 'number' && !t.hideField --><!-- ngIf: t.type === 'stripe' && !t.hideField -->
</div><!-- end ngRepeat: t in waiver.Additionals -->
<div ng-repeat="t in waiver.Additionals" class="ng-scope">
<!-- ngIf: t.type === 'textBox' && !t.hideField --><!-- ngIf: t.type === 'checkBox' && !t.hideField --><!-- ngIf: t.type === 'initial' && !t.hideField --><!-- ngIf: t.type === 'multiple' && !t.hideField --><!-- ngIf: t.type === 'shortAns' && !t.hideField --><!-- ngIf: t.type === 'date' && !t.hideField --><!-- ngIf: t.type === 'address' && !t.hideField --><!-- ngIf: t.type === 'name' && !t.hideField --><!-- ngIf: t.type === 'newName' && !t.hideField --><!-- ngIf: t.type === 'phone' && !t.hideField --><!-- ngIf: t.type === 'email' && !t.hideField --><!-- ngIf: t.type === 'dob' && !t.hideField -->
<div ng-if="t.type === 'dob' && !t.hideField" class="form-group ng-scope" ng-hide="!waiver.showMinorTemplate && t.minorsOnly && (waiver.Settings.minor.enable == 'true')"><span><strong class="ng-binding">Date of Birth:
<span class="requiredRed" ng-hide="t.optional == true">*</span></strong><!-- ngIf: waiver.platform != 'IOS' && t.format --></span><!-- ngIf: t.ageRange --><!-- ngIf: t.value != 'NaN-NaN-NaN' -->
<div ng-if="t.value != 'NaN-NaN-NaN'" class="ng-scope"><span class="ng-binding">Mar 19, 1963</span> <strong class="ng-binding">(Age: 60)</strong></div><!-- end ngIf: t.value != 'NaN-NaN-NaN' -->
</div>
<!-- end ngIf: t.type === 'dob' && !t.hideField --><!-- ngIf: t.type === 'gender' && !t.hideField --><!-- ngIf: t.type === 'country' && !t.hideField --><!-- ngIf: t.type === 'video' && !t.hideField --><!-- ngIf: t.type === 'takePic' && t.value && !t.hideField --><!-- ngIf: t.type === 'upLocalImg' && t.value && !t.hideField --><!-- ngIf: t.type === 'image' && t.value && !t.hideField --><!-- ngIf: t.type === 'photoOrFile' && t.value && !t.hideField --><!-- ngIf: t.type === 'signature' && !t.hideField --><!-- ngIf: t.type === 'number' && !t.hideField --><!-- ngIf: t.type === 'stripe' && !t.hideField -->
</div><!-- end ngRepeat: t in waiver.Additionals -->
<div ng-repeat="t in waiver.Additionals" class="ng-scope">
<!-- ngIf: t.type === 'textBox' && !t.hideField --><!-- ngIf: t.type === 'checkBox' && !t.hideField --><!-- ngIf: t.type === 'initial' && !t.hideField --><!-- ngIf: t.type === 'multiple' && !t.hideField --><!-- ngIf: t.type === 'shortAns' && !t.hideField --><!-- ngIf: t.type === 'date' && !t.hideField --><!-- ngIf: t.type === 'address' && !t.hideField --><!-- ngIf: t.type === 'name' && !t.hideField --><!-- ngIf: t.type === 'newName' && !t.hideField --><!-- ngIf: t.type === 'phone' && !t.hideField -->
<div ng-if="t.type === 'phone' && !t.hideField" class="form-group ng-scope" ng-hide="!waiver.showMinorTemplate && t.minorsOnly && (waiver.Settings.minor.enable == 'true')"><span><strong class="ng-binding">Phone
Number:<span class="requiredRed" ng-hide="t.optional == true">*</span></strong></span>
<div><span class="ng-binding">619-254-0584</span></div>
</div>
<!-- end ngIf: t.type === 'phone' && !t.hideField --><!-- ngIf: t.type === 'email' && !t.hideField --><!-- ngIf: t.type === 'dob' && !t.hideField --><!-- ngIf: t.type === 'gender' && !t.hideField --><!-- ngIf: t.type === 'country' && !t.hideField --><!-- ngIf: t.type === 'video' && !t.hideField --><!-- ngIf: t.type === 'takePic' && t.value && !t.hideField --><!-- ngIf: t.type === 'upLocalImg' && t.value && !t.hideField --><!-- ngIf: t.type === 'image' && t.value && !t.hideField --><!-- ngIf: t.type === 'photoOrFile' && t.value && !t.hideField --><!-- ngIf: t.type === 'signature' && !t.hideField --><!-- ngIf: t.type === 'number' && !t.hideField --><!-- ngIf: t.type === 'stripe' && !t.hideField -->
</div><!-- end ngRepeat: t in waiver.Additionals -->
<div ng-repeat="t in waiver.Additionals" class="ng-scope">
<!-- ngIf: t.type === 'textBox' && !t.hideField --><!-- ngIf: t.type === 'checkBox' && !t.hideField --><!-- ngIf: t.type === 'initial' && !t.hideField --><!-- ngIf: t.type === 'multiple' && !t.hideField --><!-- ngIf: t.type === 'shortAns' && !t.hideField --><!-- ngIf: t.type === 'date' && !t.hideField --><!-- ngIf: t.type === 'address' && !t.hideField --><!-- ngIf: t.type === 'name' && !t.hideField --><!-- ngIf: t.type === 'newName' && !t.hideField --><!-- ngIf: t.type === 'phone' && !t.hideField --><!-- ngIf: t.type === 'email' && !t.hideField -->
<div ng-if="t.type === 'email' && !t.hideField" class="form-group ng-scope" ng-hide="!waiver.showMinorTemplate && t.minorsOnly && (waiver.Settings.minor.enable == 'true')"><span><strong class="ng-binding">Email: <span
class="requiredRed" ng-hide="t.optional == true">*</span></strong></span>
<div><span class="ng-binding">john.lee@se.com</span></div>
</div>
<!-- end ngIf: t.type === 'email' && !t.hideField --><!-- ngIf: t.type === 'dob' && !t.hideField --><!-- ngIf: t.type === 'gender' && !t.hideField --><!-- ngIf: t.type === 'country' && !t.hideField --><!-- ngIf: t.type === 'video' && !t.hideField --><!-- ngIf: t.type === 'takePic' && t.value && !t.hideField --><!-- ngIf: t.type === 'upLocalImg' && t.value && !t.hideField --><!-- ngIf: t.type === 'image' && t.value && !t.hideField --><!-- ngIf: t.type === 'photoOrFile' && t.value && !t.hideField --><!-- ngIf: t.type === 'signature' && !t.hideField --><!-- ngIf: t.type === 'number' && !t.hideField --><!-- ngIf: t.type === 'stripe' && !t.hideField -->
</div><!-- end ngRepeat: t in waiver.Additionals -->
<div ng-repeat="t in waiver.Additionals" class="ng-scope">
<!-- ngIf: t.type === 'textBox' && !t.hideField --><!-- ngIf: t.type === 'checkBox' && !t.hideField --><!-- ngIf: t.type === 'initial' && !t.hideField --><!-- ngIf: t.type === 'multiple' && !t.hideField --><!-- ngIf: t.type === 'shortAns' && !t.hideField -->
<div class="additional ng-scope" ng-if="t.type === 'shortAns' && !t.hideField" ng-hide="!waiver.showMinorTemplate && t.minorsOnly && (waiver.Settings.minor.enable == 'true')">
<div class="form-group"><span><strong class="ng-binding">Company<span class="requiredRed ng-hide" ng-hide="t.optional == true">*</span></strong></span>
<div><span class="ng-binding"></span></div>
</div>
</div>
<!-- end ngIf: t.type === 'shortAns' && !t.hideField --><!-- ngIf: t.type === 'date' && !t.hideField --><!-- ngIf: t.type === 'address' && !t.hideField --><!-- ngIf: t.type === 'name' && !t.hideField --><!-- ngIf: t.type === 'newName' && !t.hideField --><!-- ngIf: t.type === 'phone' && !t.hideField --><!-- ngIf: t.type === 'email' && !t.hideField --><!-- ngIf: t.type === 'dob' && !t.hideField --><!-- ngIf: t.type === 'gender' && !t.hideField --><!-- ngIf: t.type === 'country' && !t.hideField --><!-- ngIf: t.type === 'video' && !t.hideField --><!-- ngIf: t.type === 'takePic' && t.value && !t.hideField --><!-- ngIf: t.type === 'upLocalImg' && t.value && !t.hideField --><!-- ngIf: t.type === 'image' && t.value && !t.hideField --><!-- ngIf: t.type === 'photoOrFile' && t.value && !t.hideField --><!-- ngIf: t.type === 'signature' && !t.hideField --><!-- ngIf: t.type === 'number' && !t.hideField --><!-- ngIf: t.type === 'stripe' && !t.hideField -->
</div><!-- end ngRepeat: t in waiver.Additionals -->
<div ng-repeat="t in waiver.Additionals" class="ng-scope"><!-- ngIf: t.type === 'textBox' && !t.hideField --><!-- ngIf: t.type === 'checkBox' && !t.hideField -->
<div class="additional ng-scope" ng-if="t.type === 'checkBox' && !t.hideField" ng-hide="!waiver.showMinorTemplate && t.minorsOnly && (waiver.Settings.minor.enable == 'true')"><span><!-- ngIf: t.checked -->
<!-- ngIf: !t.checked --><img ng-if="!t.checked" src="https://waiverphoto.s3.amazonaws.com/images/OLBuV6-unchecked.png" class="checkmark ng-scope"><!-- end ngIf: !t.checked --> <strong class="ng-binding">By checking this box, I agree to
receive promotional and marketing material from Tee Line, LLC<span class="requiredRed ng-hide" ng-hide="t.optional == true">*</span></strong></span></div>
<!-- end ngIf: t.type === 'checkBox' && !t.hideField --><!-- ngIf: t.type === 'initial' && !t.hideField --><!-- ngIf: t.type === 'multiple' && !t.hideField --><!-- ngIf: t.type === 'shortAns' && !t.hideField --><!-- ngIf: t.type === 'date' && !t.hideField --><!-- ngIf: t.type === 'address' && !t.hideField --><!-- ngIf: t.type === 'name' && !t.hideField --><!-- ngIf: t.type === 'newName' && !t.hideField --><!-- ngIf: t.type === 'phone' && !t.hideField --><!-- ngIf: t.type === 'email' && !t.hideField --><!-- ngIf: t.type === 'dob' && !t.hideField --><!-- ngIf: t.type === 'gender' && !t.hideField --><!-- ngIf: t.type === 'country' && !t.hideField --><!-- ngIf: t.type === 'video' && !t.hideField --><!-- ngIf: t.type === 'takePic' && t.value && !t.hideField --><!-- ngIf: t.type === 'upLocalImg' && t.value && !t.hideField --><!-- ngIf: t.type === 'image' && t.value && !t.hideField --><!-- ngIf: t.type === 'photoOrFile' && t.value && !t.hideField --><!-- ngIf: t.type === 'signature' && !t.hideField --><!-- ngIf: t.type === 'number' && !t.hideField --><!-- ngIf: t.type === 'stripe' && !t.hideField -->
</div><!-- end ngRepeat: t in waiver.Additionals -->
<div ng-repeat="t in waiver.Additionals" class="ng-scope">
<!-- ngIf: t.type === 'textBox' && !t.hideField --><!-- ngIf: t.type === 'checkBox' && !t.hideField --><!-- ngIf: t.type === 'initial' && !t.hideField --><!-- ngIf: t.type === 'multiple' && !t.hideField --><!-- ngIf: t.type === 'shortAns' && !t.hideField --><!-- ngIf: t.type === 'date' && !t.hideField -->
<div ng-if="t.type === 'date' && !t.hideField" ng-hide="!waiver.showMinorTemplate && t.minorsOnly && (waiver.Settings.minor.enable == 'true')" class="ng-scope">
<div class="form-group"><span><strong class="ng-binding">Signed Date:<span class="requiredRed" ng-hide="t.optional == true">*</span></strong><!-- ngIf: waiver.platform != 'IOS' && t.format --></span><!-- ngIf: t.value != 'NaN-NaN-NaN' -->
<div ng-if="t.value != 'NaN-NaN-NaN'" class="ng-scope"><span class="ng-binding">Sep 13, 2023</span></div><!-- end ngIf: t.value != 'NaN-NaN-NaN' -->
</div>
</div>
<!-- end ngIf: t.type === 'date' && !t.hideField --><!-- ngIf: t.type === 'address' && !t.hideField --><!-- ngIf: t.type === 'name' && !t.hideField --><!-- ngIf: t.type === 'newName' && !t.hideField --><!-- ngIf: t.type === 'phone' && !t.hideField --><!-- ngIf: t.type === 'email' && !t.hideField --><!-- ngIf: t.type === 'dob' && !t.hideField --><!-- ngIf: t.type === 'gender' && !t.hideField --><!-- ngIf: t.type === 'country' && !t.hideField --><!-- ngIf: t.type === 'video' && !t.hideField --><!-- ngIf: t.type === 'takePic' && t.value && !t.hideField --><!-- ngIf: t.type === 'upLocalImg' && t.value && !t.hideField --><!-- ngIf: t.type === 'image' && t.value && !t.hideField --><!-- ngIf: t.type === 'photoOrFile' && t.value && !t.hideField --><!-- ngIf: t.type === 'signature' && !t.hideField --><!-- ngIf: t.type === 'number' && !t.hideField --><!-- ngIf: t.type === 'stripe' && !t.hideField -->
</div><!-- end ngRepeat: t in waiver.Additionals -->
<div ng-repeat="t in waiver.Additionals" class="ng-scope">
<!-- ngIf: t.type === 'textBox' && !t.hideField --><!-- ngIf: t.type === 'checkBox' && !t.hideField --><!-- ngIf: t.type === 'initial' && !t.hideField --><!-- ngIf: t.type === 'multiple' && !t.hideField --><!-- ngIf: t.type === 'shortAns' && !t.hideField --><!-- ngIf: t.type === 'date' && !t.hideField --><!-- ngIf: t.type === 'address' && !t.hideField --><!-- ngIf: t.type === 'name' && !t.hideField --><!-- ngIf: t.type === 'newName' && !t.hideField --><!-- ngIf: t.type === 'phone' && !t.hideField --><!-- ngIf: t.type === 'email' && !t.hideField --><!-- ngIf: t.type === 'dob' && !t.hideField --><!-- ngIf: t.type === 'gender' && !t.hideField --><!-- ngIf: t.type === 'country' && !t.hideField --><!-- ngIf: t.type === 'video' && !t.hideField --><!-- ngIf: t.type === 'takePic' && t.value && !t.hideField --><!-- ngIf: t.type === 'upLocalImg' && t.value && !t.hideField --><!-- ngIf: t.type === 'image' && t.value && !t.hideField --><!-- ngIf: t.type === 'photoOrFile' && t.value && !t.hideField --><!-- ngIf: t.type === 'signature' && !t.hideField -->
<div ng-if="t.type === 'signature' && !t.hideField" class="form-group ng-scope" ng-hide="!waiver.showMinorTemplate && t.minorsOnly && (waiver.Settings.minor.enable == 'true')"><span><strong
class="ng-binding">Signature:<span class="requiredRed" ng-hide="t.optional == true || t.counterSign">*</span></strong></span><!-- ngIf: t.dataUrl && t.dataUrl.dataUrl && t.templateHasDataUrl -->
<div class="signatures ng-scope" ng-if="t.dataUrl && t.dataUrl.dataUrl && t.templateHasDataUrl">
<div><img class="signature-img"
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"
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</form>Text Content
100% Signed Date: Sep 14, 2023 1:12:19 AM IP Address: 99.26.183.141 NEW TEE LINE CURLING AND BOWLING WAIVER (USE THIS ONE) Tee Line Curling and Bowling Waiver I, (the “Participant”), desire to participate in curling and/or bowling activity provided by Tee Line, LLC, a Tennessee limited liability company (“Tee Line”). In consideration of Tee Line furnishing services and/or equipment to enable me to participate in the above mentioned activities, I agree as follows: I fully understand and acknowledge that: (a) the sport of curling and/or bowling requires physical fitness; (b) the sport of curling is played on ice; (c) curling and bowling have inherent risks, dangers and hazards, and such exist in my use of curling and/or bowling equipment and my participation in the above-mentioned activities and undertakings; (d) my participation in such activities, including any activity involving new and/or experimental techniques, and/or use of such equipment may result in injury or illness including, but not limited to bodily injury, disease, infectious disease, strains, fractures, partial and/or total paralysis, death or other ailments that could cause serious disability; (e) these risks and dangers may be caused by the negligence of Tee Line, or its trainers, members, directors, agents, employees or independent contractors, the negligence of me and/or other participants, the negligence of others, accidents, breaches of contract, or other causes; (f) the use of alcohol or any other intoxicating substance increases the risk of injury and Tee Line reserves the right to ask me to leave the premises if I am under the influence of any intoxicating substance; (g) risks and dangers may arise from foreseeable or unforeseeable causes including without limitation a trainer’s choice of technique or instruction; and (h) by my participation in these activities and/or use of curling and/or bowling equipment, I hereby assume all risks and dangers and all responsibility for any and all losses and/or damages, whether caused in whole or in part by the negligence or other conduct of Tee Line, and its trainers, members, directors, agents or independent contractors, or by any other person. I, on behalf of myself, my personal representatives and my heirs, or as a parent or legal guardian of the undersigned Participant (if he or she is under 18 years of age), hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify Tee Line, and its trainers, members, directors, agents, employees and independent contractors, from any and all claims, actions, or losses for bodily injury, illness, property damage, wrongful death, loss of services or otherwise which arise out of my use of curling and/or bowling equipment or my participation in curling and bowling activities. I specifically understand that I am releasing, discharging, and waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct by Tee Line, and its trainers, members, directors, agents, employees and independent contractors. I further agree that if any legal action is brought, it must be in the state courts sitting in Davidson County, Tennessee, or in the United States District Court for the Middle District of Tennessee. By entering Tee Line, you accept and acknowledge that your image may be used on social media or other promotional materials. I HAVE READ THE ABOVE WAIVER AND RELEASE AND BY SIGNING IT, AGREE IT IS MY INTENTION TO EXEMPT AND RELIEVE TEE LINE, LLC FROM LIABILITY FOR PERSONAL INJURY, ILLNESS, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE. First and last name: * John Lee Date of Birth: * Mar 19, 1963 (Age: 60) Phone Number:* 619-254-0584 Email: * john.lee@se.com Company* By checking this box, I agree to receive promotional and marketing material from Tee Line, LLC* Signed Date:* Sep 13, 2023 Signature:* Signature of Parent or Guardian (If client is under 18)* Submit Download as PDF Add Note Waiver QR Code -------------------------------------------------------------------------------- Scan here to view this waiver To open the popup, press Shift+Enter To open the popup, press Shift+Enter To open the popup, press Shift+Enter To open the popup, press Shift+Enter Paragraph System Font 16px To open the popup, press Shift+Enter p 0 words