|All ages from 10 to 17 must have a parent or guarding sign this waiver. 18 and over must also sign themselves
To Print just the Waiver; If using Internet Explorer, Right Click and select Print Picture. If using Firefox use the drop box and click print.
| Wyldside Paintball
4500 Rotary Rd.
New Milford, Illinois
Phone: (815) 398 -9953
Industry Insurance Programs
WAIVER AND RELEASE OF LIABILITY
In consideration of Wyldside Inc. furnishing services and/or equipment to enable me to participate in paintball games, I agree as
I fully understand and acknowledge that; (A) risks and dangers exist in my use of paintball equipment and my participation of
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, and/or total paralysis, eye injury, blindness, heart stroke and heart
attack, death, or other ailments that could cause serious disability; (C) these risks and dangers may be caused by negligence of
the owners, employees, officers and/or agents of Wyldside Inc; the negligence of participants, the negligence of others,
accidents, breeches the contract; the forces of nature or other causes. These risks and dangers may arise from unforeseeable
or unforeseeable causes; and (D) by my participation in these activities and/or use of equipment, I hereby assume all risk of
danger and all responsibility for all loses and/or damages, whether causes in whole or in part to the negligence or other conduct
of the owners, agents, officers, and employees of Wyldside Inc., or by any other person.
I, on behalf of myself, my personal representatives and my heirs, hereby voluntary agree to release, waive, hold harmless,
defend and indemnify Wyldside Inc. and its owners, agents, officers, and employees of Wyldside Inc. 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 conducts by the owners
agents, officers, and employees of Wyldside Inc. This waiver is good till 12/31/2012.
I HAVE READ THE ABOVE WAIVER AND RELEASE AND BY SIGNING IT I AGREE THAT IT IS MY INTENTION TO EXEMPT AND
RELIEVE WYLDSIDE INC. FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE, AND OR WRONGFUL DEATH
CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE.
__________________________________ ______ _________________ ________________________
Print Name Age Date of birth Phone
Signature of Parent/Guardian City, State, Zip
(if less than 18 years of age)