www.3rdPlanetGamers.

com
3rdplanetgamers@gmail.com

Game Admission Waiver Form

Ratings: 3rdPlanetGamers supports and adheres to the industry rating system for computer and video
games and the voluntary enforcement of this rating system. Any person wanting to participate in the
game play must be 12 years old in order to be considered eligible. Any participant or spectator who is
not at least 18 years of age is prohibited from playing "T" or (Teen) or "M" (Mature) rated software
respectively without the signed consent of a parent/ legal. This form must be filled out completely by
the parent or legal guardian of the applicant indicated below. Proper identification is defined as
(unexpired State Driver’s License, State ID, or Passport). If you are under the age of 18 and do not have
written parental consent, you may not play “T” or “M” rated games. If you are under the age of twelve
years old (12) you must have a signed parental consent form on file and are supervised by an adult 21
years or older claiming responsibility for you.

Equipment: You will be held liable for any equipment you break or damage during the course of any
rental at 3rdPlanetGamers and Season Ticket Family Pizza. This includes any equipment that may be lost
or stolen. 3rdPlanetGamers equipment includes but is not limited to televisions, game systems, games,
cables, headsets, couches, furniture, décor, costumes or anything you interact with at 3rdPlanetGamers.
Full replacement value will be charged to you if items are broken or damaged.

Language: Profane, derogatory, slanderous and abusive language is not permitted while at
3rdPlanetGamers and Season Ticket Family Pizza. While friendly banter is acceptable, any blatant
profanity is unacceptable and you will be asked to leave 3rdPlanetGamers and Season Ticket Family
Pizza without a refund.

Monitoring: 3rdPlanetGamers and Season Ticket Family Pizza monitors your full experience and the
premise contains a full camera system.

Fighting: No fighting or aggression will be tolerated. The police will be called and you will be escorted
out of 3rdPlanetGamers and Season Ticket Family Pizza with no refund.

Liability Release: By signing below, you release any and all liabilities that may arise while entering the
premises of 3rdPlanetGamers and Season Ticket Family Pizza. You also agree to assume responsibility
for any items or property stolen, lost, or damaged and/or any minor or serious injury, whether
accidental or intentional, while at 3rdPlanetGamers and Season Ticket Family Pizza or in its surrounding
vicinity. In the event that you or your child/legal ward may need medical attention, you authorize us to
notify proper authorities and call an ambulance.

SIGNATURE:__________________________________________ DATE:___________

Full Name: ______________________________________

Address: ______________________________________ City:____________________ State: _____

Phone#:_____________________________ Email:_____________________________