I am checking this box acknowledge that it will be valid as a E-Signature for this Waiver and Release indemnity agreement, and informed consent ( hereinafter “ Waiver & Release”) in anticipation of my entering the warehouse of Reliance Granite and Marble Corporation ( “Reliance” or “we” or “our” or “us”) located at 50 Boright avenue, Kenilworth, NJ 07033 (‘“PERMISES”).
I understand that Reliance is located in a commercial area and the premises contain a wholesale warehouse. Reliance is involved in receiving, handling, dispatching, storing and selling natural stone tiles and slabs in various shapes, sizes, weights, colors and thickness which necessarily involves heavy traffic and activities in movement of workers, materials, material-handling equipment, including but not limited to forklifts, overhead cranes, pallet lift jacks, pickups, trailers, flatbed trucks and other heavy and dangerous equipment. Stones are heavy and may have sharp or jagged surfaces and edges. The nature of this business and scope of operations involves use of tools, including but not limited to Crowbars, Hammers, Wood cutting saws and steel cables. As a result, debris such as wood bark, nails, plastic sheets, broken boxes and various additional sharp, heavy, sleeper, etc. objects may lie on the floor of the premises in the normal course of work. As a result of the foregoing, customers entering the premises without them, including but not limited to the following provisions, all of which apply regardless of whether I am wearing a hard hat, gloves, or other protective gear, garments, footwear or equipment.
I Understand that my presence on the premises poses unique risks of injury, and even death, oh which I am fully aware. I agree: (1) not move around the premises alone/unattended and to ask for help/assistance with materials/products and moving about the premises: (2) to be vigilant, careful, alert and aware of ongoing activities and tripping hazards while walking in the premises and between aisles; (3) to no use any mobile or electronic device in the premises including but not limited to talking on a mobile device, texting, emailing, internet searching etc. I understand that doing so will prevent me from being fully aware of my surroundings at all times; (4) that any person under the age of 16 must remain in the waiting area having strictly prohibited their access to the warehouse area. If such are brought into the warehouse without our permission the child(ren)’s parents, guardians and/or caretakers are solely responsible for their safety; (5) to avoid moving into confined areas and areas with insufficient or dim lighting; (6) not to attempt to lift or move any stones, tiles or objects; (7) not to touch any machines, equipment, materials, etc. in the premises; (8) to obey all rules and instructions explained to me by Reliance staff; and (9) to ask us questions and for any additional safety information.
I acknowledge that checking the acceptance box will be used as my signature. Providing my understanding and agreement that any bodily injury, death or loss of personal property, damages and expenses are my sole responsibility and all information shared
I further agree and understand that I have read this waiver & release carefully and I am aware that by signing it, I will be waiving and releasing all claims for personal injuries and property damage that I sustain while on the premises. I acknowledge that Reliance has made no warranty, express or implied, regarding the condition of the premises or the materials or equipment thereat, or the physical or mental condition, competency or skills of any other person at the premises or elsewhere.
I have had ample opportunity to review this document and ask questions about all of the risk presented herein. notwithstanding this risk, both disclosed and undisclosed, I fully assume these risks and the inherently dangerous nature of the premises and it is with my full and complete knowledge of these risks that, to the full extent permitted by New Jersey Law, I agree to hold harmless, release, defend, and indemnify Reliance and to waive and relinquish all claims, demands, costs, losses, expenses or compensations of whatever nature for any loss, damage or injuries to persons and property sustained by me any children in my care, my heirs, personal representati9ves, successors, assigns and all other persons I may have or which in the future may accrue to the above-referenced individuals or entities against Reliance, Its owners, officers, principals, agents, successors, assigns, heirs, employees, volunteers and independent contractors.
This waiver & Release covers any and all liability, claims, demands, causes of action or damages of any kind related to arising from, or in any way connected with or believed to be caused by: (a) Reliance or its employees; (b) any other individuals merely present and premises; or (c) me at the premises. This waiver & release covers any and all activities connected to or associated with my presence at the premises all without limitation. I further agree not to sue, claim against, attach the property of, or prosecute Reliance for any such injury, death, damages or losses whether or not such injury or death was caused in whole or in part by my negligence, the negligence of Reliance, or the act or omission of any party whatsoever.
This Contract shall be legally binding upon me, my spouse, my heirs, my state, assigns, legal guardians, and my personal representatives. I agree that this waiver & release is intended to be as broad and inclusive as permitted by the laws of the state of New Jersey and that if any portion of this waiver & release is held invalid the other provisions of this waiver & release and any dispute arising in connection with it shall be governed by and construed in accordance with New Jersey Law.
I as a parent/guardian/supervisor/caretaker (of a minor), an individual 16 years old of age or older, check the box with full acknowledge this is accepted as a signature. Sign this Waiver & Release on behalf of said minor, understanding that this waiver & release shall be deemed binding to the fullest extent permitted by law with respect to said minor. The consent of one parent or legal guardian shall be deemed the consent of all persons legally responsible for this individual, even if only one such person signs this Waiver & Release.
I am not under the influence of any medication, alcohol or controlled substance that would impair my judgement to enter into this Waiver & Release or comply with its terms while on the premises.
I HAVE READ THIS CONVENANT NOT TO SUE, WAIVER, RELEASE, INFORMED CONSENT, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE A COMPLETE AN UNCONDITIONAL RELEASE OF RELIANCE AND ALL PARTIES MENTIONED HEREIN TO THE GREATEST EXTENT ALLOWED BY LAW THIS IS A RELEASE OF LIABILITY. DO NOT CHECK THE BOX OR ACCEPT (E-SIGNATURE) IN THIS DOCUMENT IF YOU DO NOT UNDERSTAND OR DO NOT AGREE WITH ITS TERMS.