The Study Bar - New Member Registration

The Study Bar - New Member Registration

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The Study Bar New Member Registration
New Member Registration Form
  • 1
    Welcome to The Study Bar!
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  • 2
    Nice to meet you! What's your name?
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  • 3
    How old are you?
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    • 13-17
    • +18
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    *For clients under the age of 18
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    *Please provide First & Last names for each individual
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    • Please Select
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  • 13
    • Coffee
    • Soda
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  • 15


    The Study Bar/Agile Solutions Group, LLC
    711 Old Ballas Road, Suite 215
    St. Louis Mo 63141
    314.736.4200
    Waiver of Liability & Hold Harmless Agreement

    In consideration of agreement by The Study Bar to participate in The Study Bar (“the Program”), and as consideration for the right to participate in the Program, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this waiver and release of liability and hereby waive any and all rights, claims and causes of action of any kind whatsoever arising out of my participation in the Program, and do hereby release and forever discharge The Study Bar, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economic loss, that I may suffer as a direct result of my participation in the aforementioned Program, including traveling to and from an event related to this Program.

    I am fully aware that my participation in the Program is totally voluntary.

    In consideration of The Study Bar’s agreement to permit me to participate in the aforementioned Program, the receipt and sufficiency in which consideration is hereby acknowledged, I further agree as follows:

    1. I, individually, and on behalf of my respective heirs, successors, assigns and personal representatives, hereby release, acquit and forever discharge The Study Bar and its employees, students, agents, servants, officers, trustees and representatives (in their official and individual capacities) from any and all liability whatsoever for any and all damages, losses or injuries, including death, mental anguish or emotional distress to me and/or property, including but not limited to any claims, demands, actions, causes of action, damages, costs, expenses (including hospital and medical expenses) and attorney fees, which arise out of, occur during, or result from my participation in the Program including travel to and from The Study Bar.

    2. In addition to immediately contacting the “Emergency Contact Person” as listed on this form and in the event of a medical emergency, I solely give permission to the persons involved with the Program to call 911 and/or administer appropriate primary medical attention to me in the event of any accident , illness, or injury, as needed. I will be responsible for any and all costs of medical coverage and treatment provided not covered by my personal insurance. I acknowledge and signify that I have read and understand this waiver and I will sign it voluntarily.

    3. I, individually, and on behalf of our representative heirs, successors, assigns and personal representatives, hereby agree to indemnify, defend and hold harmless, The Study Bar, and its employees, students, agents, servants, officers, trustees, and representatives (in their official and individual capacities) from any and all liability, loss or damage they or any of them incur or sustain as a result of any claims, demands, actions, causes of action judgments, costs or expenses, including attorney fees, which result from, arise out of, or relate to my participation in the aforementioned Program or arising out of my travel to or from The Study Bar.

    4. I agree that this waiver, release and Indemnification Agreement is intended to be as broad and inclusive as permitted by the laws of the State of Missouri, and if any portion hereof is held invalid, it is agreed that the balance hereof shall notwithstanding, continue in full legal force and effect.

    5. I herebye acknowledge and accept that there are certain risks, known and unknown, including bodily injury and death that could result from my participation in the aforementioned Program at The Study Bar. I have knowingly and voluntarily decided to assume the risks of these inherent dangers in consideration of The Study Bar’s permission to allow me to participate in the aforementioned Program. I, Individually hereby release and discharge The Study Bar from any and all negligence, including The Study Bar’s own negligence, in connection with my attendance at or participation in the Program, including travel to and from The Study Bar, and including gross negligence, but except for any willful and wanton misconduct on part of The Study Bar.

    6. I agree that I will promptly communicate any problems or issues associated with my participation in the Program with The Study Bar Founder. I further agree that I will promptly report and disclose to The Study Bar Founder all pertinent information concerning my ability to participate successfully in the Program.

    7. I agree that I may be photographed, audio or videotaped while participating at The Study Bar. I agree that photographic image(s) and information that correspond with the photographic image(s) may be disseminated for any public usage by The Study Bar.

    8. I agree that I will abide by all of the rules and regulations and, if found in violation, may be removed from the Program either temporarily or permanently. I understand The Study Bar may withdraw my participation if these Programs are disrupted or altered in any way by my behavior. I further agree that, I take full responsibility for the behavior and conduct of myself and any consequences resulting from my actions.

    9. I hereby understand and acknowledge that The Study Bar Program will take place throughout the various days of the week at The Study Bar located at 711 Old Ballas Road Suite 215 St. Louis MO 63141. I agree that is my responsibility entirely to transport or arrange transport for myself to and from The Study Bar. I agree that it is my responsibility to leave by the time posted.

    10. In the event that any provision contained within this Waiver and Release of Liability shall be deemed to be invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the clause severed does not affect the intent of the parties. If a court should find any provision of this agreement to be invalid or unenforceable, by that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited

    11. The Study Bar is not responsible for lost, stolen or damaged personal property brought into The Study Bar.

    By completing the membership agreement for the Program, I understand that I have read and understand this waiver and release, and I am aware that by completing the membership agreement for the Program, I am waiving certain legal rights which I or my Heirs, next of kin, executors, administrators, and assigns may have against The Study Bar. I, Individually hereby release and discharge The Study Bar from any and all negligence, including The Study Bar’s own negligence, in connection with my attendance at or participation in the Program, including travel to and from The Study Bar, and including gross negligence, but except for any willful and wanton misconduct on part of The Study Bar.

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  • 16

    The Study Bar/Agile Solutions Group, LLC
    711 Old Ballas Road, Suite 215
    St. Louis Mo 63141
    314.736.4200
    Waiver of Liability & Hold Harmless Agreement

    In consideration of agreement by The Study Bar to permit my minor child/children to participate in The Study Bar (“the Program”), and as consideration for the right to participate in the Program, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this waiver and release of liability and hereby waive any and all rights, claims and causes of action of any kind whatsoever arising out of my participation in the Program, and do hereby release and forever discharge The Study Bar, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economic loss, that he/she/they may suffer as a direct result of their participation in the aforementioned Program, including traveling to and from an event related to this Program.

    I am fully aware that my child/children’s participation in the Program is totally voluntary.

    In consideration of The Study Bar’s agreement to permit my child/children to participate in the aforementioned Program, the receipt and sufficiency in which consideration is hereby acknowledged, I further agree as follows:

    1. I am the child/children’s parent or legal guardian.

    2. I, individually, and on behalf of my minor child/children and our respective heirs, successors, assigns and personal representatives, hereby release, acquit and forever discharge The Study Bar and its employees, students, agents, servants, officers, trustees and representatives (in their official and individual capacities) from any and all liability whatsoever for any and all damages, losses or injuries, including death, mental anguish or emotional distress to my child and/or property, including but not limited to any claims, demands, actions, causes of action, damages, costs, expenses (including hospital and medical expenses) and attorney fees, which arise out of, occur during, or result from my child’s participation in the Program including travel to and from The Study Bar and including without limitation any loss, claim, demand or suit that my child might assert once he/she attains the age of majority.

    3. In addition to immediately contacting the “Emergency Contact Person” as listed on this form and in the event of a medical emergency, I solely give permission to the persons involved with the Program to call 911 and/or administer appropriate primary medical attention to my child/children in the event of any accident , illness, or injury, as needed. I will be responsible for any and all costs of medical coverage and treatment provided not covered by my personal insurance. I acknowledge and signify that I have read and understand this waiver and I will sign it voluntarily.

    4. I, individually, and on behalf of my minor child/children and our representative heirs, successors, assigns and personal representatives, hereby agree to indemnify, defend and hold harmless, The Study Bar, and its employees, students, agents, servants, officers, trustees, and representatives (in their official and individual capacities) from any and all liability, loss or damage they or any of them incur or sustain as a result of any claims, demands, actions, causes of action judgments, costs or expenses, including attorney fees, which result from, arise out of, or relate to my child's participation in the aforementioned Program or arising out of his or her travel to or from The Study Bar.

    5. I agree that this waiver, release and Indemnification Agreement is intended to be as broad and inclusive as permitted by the laws of the State of Missouri, and if any portion hereof is held invalid, it is agreed that the balance hereof shall notwithstanding, continue in full legal force and effect.

    6. I hereby acknowledge and accept that there are certain risks, known and unknown, including bodily injury and death that could result from my child/children’s participation in the aforementioned Program at The Study Bar. I have knowingly and voluntarily decided to assume the risks of these inherent dangers in consideration of The Study Bar’s permission to allow my minor child/children to participate in the aforementioned Program. I, Individually and on behalf of my minor child/children hereby release and discharge The Study Bar from any and all negligence, including The Study Bar’s own negligence, in connection with my childs/childrens attendance at or participation in the Program, including travel to and from The Study Bar, and including gross negligence, but except for any willful and wanton misconduct on part of The Study Bar.

    7. As parent of the child/children, we agree that I will promptly communicate any problems or issues associated with the child/children’s participation in the Program with The Study Bar Founder. I further agree that I will promptly report and disclose to The Study Bar Founder all pertinent information concerning the child/children’s ability to participate successfully in the Program.

    8. I agree that the child/children may be photographed, audio or videotaped while participating at The Study Bar. I agree that photographic image(s) and information that correspond with the photographic image(s) may be disseminated for any public usage by The Study Bar.

    9. I agree that the child/children will abide by all of the rules and regulations and, if found in violation, may be removed from the Program either temporarily or permanently. I understand The Study Bar may withdraw the child/children’s participation if these Programs are disrupted or altered in any way by the child/children’s behavior. I further agree that as a parent or guardian of the child/children, I take full responsibility for the behavior and conduct of the child/children and any consequences resulting from their actions.

    10. I hereby understand and acknowledge that The Study Bar Program will take place throughout the various days of the week at The Study Bar located at 711 Old Ballas Road Suite 215 St. Louis MO 63141. I agree that is my responsibility entirely to transport or arrange transport for my minor child/children to and from The Study Bar. I agree that it is my responsibility to pick up my child/children by the time posted from The Study Bar.

    11. In the event that any provision contained within this Waiver and Release of Liability shall be deemed to be invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the clause severed does not affect the intent of the parties. If a court should find any provision of this agreement to be invalid or unenforceable, by that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited

    12. The Study Bar is not responsible for lost, stolen or damaged personal property brought into The Study Bar by the child/children.

    By completing the membership agreement for the Program, I understand that I have read and understand this waiver and release and I am waiving certain legal rights which I or my Heirs, next of kin, executors, administrators, and assigns may have against The Study Bar. I, Individually, hereby release and discharge The Study Bar from any and all negligence, including The Study Bar’s own negligence, in connection with my childs/childrens attendance at or participation in the Program, including travel to and from The Study Bar, and including gross negligence, but except for any willful and wanton misconduct on part of The Study Bar.

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