SPECIAL FORMS FOR MINORITY AGE
PLAYERS 12-17
NOTE: THIS FORM MUST BE READ AND SIGNED
BEFORE THE PARTICIPANT IS ALLOWED TO TAKE PART IN ANY PAINTBALL EVENT.
PARTICIPANT'S
NAME____________________________________ DATE OF BIRTH ____________
IN CONSIDERATION of being permitted to participate in any way in the sport and
activities of paintball under the auspices of TEXAS JUSTICE PAINTBALL, I
acknowledge, appreciate, and agree that:
1. The risk of injury from the activity and weaponry involved in paintball is significant, including the potential for permanent disability and death, and while particular protective equipment and personal discipline will minimize this risk, the risk of serious injury does exist;
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN ARISING FROM THE NEGLIGENCE of those persons released from liability below, and assume full responsibility for my participation; and,
3. I understand that the activities of paintball are physically and mentally intense. I understand the rules of play and will comply with all rules and regulations. If I observe any unusual or unnecessary hazard during my participation, I will bring such to the attention of the nearest official as soon as practical; and,
4. I, for myself and on behalf of my heirs, assigns, personal representatives and nest of kin, HEREBY RELEASE AND HOLD HARMLESS TEXAS JUSTICE PAINTBALL,. the owners and lessors of premises used to conduct the paintball activities, their officers, officials, agents and/or employees ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, except that which is the result of gross negligence and/or wanton misconduct.
5. I understand and agree that this Release of
Liability Agreement covers each and every paintball activity and event in which
I participate hereafter.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY
UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY
SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
_________________
PARTICIPANT'S PRINTED NAME
x____________________________________ Date
Signed:_________ Phone#_______________
PARTICIPANT'S SIGNATURE
_____________________________________________
_______________________ __________
ADDRESS
PARENT OR GUARDIAN MUST READ THIS FORM AND SIGN BELOW
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree not only to his/her release of the Texas Justice Paintball and all other Releasees but also to release and indemnify the Releasees from any and all liabilities incident to his/her involvement in these programs for myself, my heirs, assigns, and next of kin.
____________________
PRINTED
NAME
X__________________________________ _________________________
Date Signed:_________________
PARENT/GUARDIAN'S SIGNATURE
EMERGENCY PHONE #(S)
EMERGENCY MEDICAL PERMISSION FORM
FOR MINORITY AGE PLAYERS 12-15
The undersigned parent or guardian hereby gives permission, TEXAS JUSTICE PAINTBALL to authorize emergency medical treatment as may be deemed necessary for the child named below, while playing paintball games at TEXAS JUSTICE PAINTBALL from this date ________________ through year end.
________________________________
TELEPHONE________
NAME OF PLAYER (AGE 12 TO 15)
ADDRESS___________________________________________
CITY_________________________STATE______ZIP_________
__________________________________________________
SIGNATURE OF PARENT OR GUARDIAN
__________________________________________________
HOSPITALIZATION INSURANCE POLICY NUMBER
______________________________________
INSURANCE COMPANY