Name *
Date of Your Event at Breakout *
Date of Your Event at Breakout
By requesting your photo, you are not granting permission for future communications - just one text or email with the photo
Discounts, announcements, discounts, etc....
Terms & Conditions
I will not take pictures, film or record any part of the games. I understand that any use, copy distribution, public display or creation of any imitative work from Breakout KC, Breakout Waikiki, Breakout Lawrence, Get Out: Omaha or their subsidiaries (hereby referred to as Breakout) is prohibited. I understand that Breakout is not recommended to those with any heart conditions, hypertension, claustrophobia or similar conditions. I understand that Breakout may email me from time to time and that I will be able to unsubscribe at any time. I hereby grant to the Facilitator the right to photograph, videotape or otherwise capture my image, appearance or likeness and to use such images for any legitimate purposes, commercial or otherwise. I understand that I have to act in accordance with the Breakout rules for my own safety. The parties agree that if loss or damage should result from the failure of performance or participation in the services and game at Breakout, that Breakout's liability, if any, for the loss or damage thus sustained shall be waived and that the provisions of this paragraph shall apply if loss or damage results from negligence of Breakout, its agents or employees. Participant waives his or her claims even if the cause of damages or injuries are alleged to be the fault or caused by the negligence of Breakout. Any participant under the age of 13 is required to have a parent or legal guardian agree to these terms and provide a signature.
I accept the terms and conditions. *