
4412 Hwy 82 & Anne Drive-In
Leland, MS 38756
ph: 662-820-0067
fax: 662-686-7223
mcgyver
Paintball Holdharmless & Waiver
EACH INDIVIDUAL MUST READ AND SIGN
THIS RELEASE OF LIABILITY PRIOR TO PARTICIPATION
In order to participate in these activites, I the undersigned agree and acknowledge that:
there is risk of injury, including a potential for permanent disability or death resulting from participation in these activities or from the equipment involved,
I freely assume all such risks both known and unknown and assume full responsibility for my participation,I have read and understand the rules, including all safety-related rules, and agree to fully comply with all regulations during my participation,
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin hereby release and hold harmless Keith Bevill dba Delta Paintball Park LLC or Robert Upshur, their officers, officials, agents and or employees, from any and all liability for injury, disability, death, loss or damage to personal property,
I acknowledge, understand and agree that i have read this release of liability and assume all risk associated with participating and that i sign this release of liability voluntarily and without inducement.
_____________________________ _____________________ ______________
PARTICIPANTS NAME (please print) PARTICIPANTS SIGNATURE DATE
________________________________ _________________ ________________
HOME ADDRESS CITY PHONE # Email ADDRESS
MINOR AGED PARTICIPANTS
All players under the age of 18 at the time of participation must have a parent or guardian sign below.I certify that I am the parent or guardian with legal responsibility for the above signed participant and agree to his/her release. I also agree to indemnify the above named companies and individuals from all liabilities resulting from his/her participation in these activities for myself, my heirs, assigns, and next of kin.
_____________________________ _________________________
PARENT/GUARDIAN'S SIGNATURE DATED SIGNED
-WAIVERS ARE HELD ON FILE AND ARE VALID FOR ONE YEAR-
Prefered clothing should be loose fitting long sleeved shirt , long pants , and comfortable athletic shoes.
Note:
To print the Waiver, right click to select the text, then print selected
4412 Hwy 82 & Anne Drive-In
Leland, MS 38756
ph: 662-820-0067
fax: 662-686-7223
mcgyver