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| www.wyldpaintball.com |
| 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 READ CAREFULLY 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 follows: 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 Address __________________________________ _______________________________________________________ Signature of Parent/Guardian City, State, Zip (if less than 18 years of age) _________________ _______________________________________________________ Date E-Mail |