Waiver and Release Agreement The undersigned hereby acknowledges that there are dangers inherent in glassblowing, glass working, and other related activities, and that property damage, serious personal injuries and even death may occur. Glassblowing, glass working and its related activities involve working in close proximity to a furnace, which generates a high level of heat and emits potentially harmful vapors, which are not visible to the participant, and handling molten glass. The risks associated with glassblowing, glass working and its related activities thus include, without limitation, physical effort, cuts, burns, inhalation of hazardous substances, and exposure to high heat. In exchange for being allowed to participate in glassblowing, glass working, and other related activities, the undersigned hereby assumes full responsibility for the risk of personal injury, death, and property damage resulting from all such activities, including all risk of injury, death or property damage resulting from the negligence or fault of the parties released by this Agreement or due to the condition of the premises upon which the activities will take place. I give permission to have my photograph taken during a class for marketing purposes. On my own behalf and on behalf of my heirs, personal representatives, and assigns, I hereby release and agree to hold harmless Jeremie Draper, individually and d/b/a JDraperGlass, and Waterstreet Unlimited, LLC, Series 925, an Illinois limited liability company, as well as each of their respective employees, agents, officers, directors, members, managers, partners, contractors, and volunteers (collectively, the “Released Parties”) of and from all claims, demands, actions, rights of action, or other legal rights to claim compensation for any loss, injury or property damage that I may sustain as a result of my participating in glassblowing, glass working, and other related activities, regardless of whether such loss, injury or property damage is caused by the negligence of the Released Parties or any condition of the premises where such activities occur, and regardless of whether such loss, injury or property damage occurs while participating in, going to, or coming from such activity. However, this waiver and release does not apply to willful and wanton conduct by the Released Parties. This Agreement contains and embodies the entire agreement and understandings between the parties concerning the subject matter hereof. YOUR SIGNATURE BELOW INDICATES THAT YOU HAVE READ AND AGREE TO THE ABOVE.Name* First Last Best Contact Phone*Email* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Today's Date* Signature*If participant is under the age of 18, parent or guardian must sign as well.Parent / Guardian Name First Last Today's Date* Parent / Guardian Signature This iframe contains the logic required to handle Ajax powered Gravity Forms.