Kamikaze Paintball Waiver
| Kamikaze Paintball of Ellijay, Inc. 372 Eller Road, Ellijay, GA 30536 Phone: 706-698-5264 e-mail: kamikazepb@ellijay.com READ CAREFULLY WAIVER AND RELEASE OF LIABILITY In consideration of Kamikaze Paintball of Ellijay, Inc. furnishing services and/ or equipment to enable me to participate in paintball games, I agree as follows: I fully understand and acknowledge that; (a) risks and dangers exist in my use of Paintball equipment and my participation in Paintball activities; (b) my participation in such activities and/ or use of such equipment may result in my injury or illness including but not limited to bodily injury, disease strains, fractures, partial and/ or total paralysis. Eye injury, blindness, heat stroke, heart attack, death or other ailments that could cause serious disability; (c) these risks and dangers may be caused by the negligence of the owners, employees, officers or agents of Kamikaze Paintball of Ellijay, Inc., the negligence of the participants, the negligence of others, accidents, breaches of contract, the forces of nature or other causes. These risks and dangers may arise from foreseeable or unforeseeable causes; and (d) by my participation in these activities and/ or use of equipment, I hereby assume all risks and dangers and all responsibility for any losses and/ or damages, whether caused in whole or in part by the negligence or other conduct of the owners, agents, officers, employees of Kamikaze Paintball of Ellijay, Inc., or by any other person. I, on behalf of myself, my personal representatives and my heirs, hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify Kamikaze Paintball of Ellijay, Inc., and it’s owners, agents, officers, and employees from any and all claims, actions or losses for bodily injury, property damage, wrongful death, loss of services, or otherwise which may arise out of my use of Paintball equipment or my participation in Paintball activities. I specifically understand that I am releasing, discharging and waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct by the owners, agents, officers, or employees of Kamikaze Paintball of Ellijay, Inc.. This waiver is good through 03/01/2009. MEDICAL PERMISSION AUTHORIZATION If the participant is of minority age, the undersigned parent of guardian hereby gives permission for Kamikaze Paintball of Ellijay, Inc. to authorize emergency medical treatment as may be deemed necessary for the child named below while participating in paintball games from this date through 03/01/2009. I HAVE READ THE ABOVE WAIVER AND RELEASE AND BY SIGNING IT, AGREE IT IS MY INTENTION TO EXEMPT AND RELIEVE Kamikaze Paintball of Ellijay, Inc. FROM PERSONAL INJURY, PROPERTY DAMAGE, OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE. _________________________________ _______ _____________ _____________________________ Print Name Age Date of Birth Phone Number _________________________________ _____________________________ _____________________ Signature Street Address City, State, Zip _________________________________ _________________________________ _________________ Signature of Parent/Guardian (if under 18 yrs old) E-Mail Address Today’s Date |