paint ball - AWS
PA I N T B A L L
GENERAL INFO Date: Sunday, April 5
Time: 2pm - 5pm
Where: Madddogz Paintball, 410 Mushroom Road
Waxahachie, TX 75165-6108 Price: $25 (check or cash - make check to Stonegate Church) Price Includes:
-Gun (you can bring your own if you want)
-Mask
-Paintballs
-Enough paintball matches to cover 3 hours!
Meeting: We are all going to just meet at Madddogs. You are free to arrange car pooling on your own.
Other info: Parents (Dads escpecially!) are more than welcome to come! You can bring additional money for snacks.
TO REGISTER
1) Fill out the Stonegate Release Form (other side of this form) 2) Fill out the Madddogs Waiver (stapled to this form of online) 3) Pay $25 Per Player (Cash or Check to Stonegate Church) & turn in to Dan Hutchins on or before April 5.
PAINTBALL 2013 RELEASE FORM
Stonegate Church Medical form (Please print legibly) I,_______________________(parent/guardian), agree to allow my child, _________________________ to attend Madddogs Paintball in Waxahachie, TX with Stonegate Church of Midlothian, TX. I also authorize medication and surgical treatment, as needed, for any accident that may occur involving my child, and release the church from any liability in the case of a medical emergency. I UNDERSTAND AND HEREBY AGREE TO ASSUME ALL OF THE RISKS WHICH MAY BE ENCOUNTERED ON SAID ACTIVITY, INCLUDINGACTIVITIES PRELIMINARY AND SUBSEQUENT THERETO. I do hereby agree to hold Stonegate Church and its agents and employees harmless from any and all liabilityaction, causes of actions claims, expenses, and damages on account of injury to my child,property, even injury resulting in death, which I now have or which may arise in the future in connection with the activity or participation in any other associated activities. I expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as permitted by the law of the State of Texas and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement between the parties hereto and the terms of this release are contractual and not a mere recital. Parent’s Signature _________________________________________ Home Phone _________________ Work Phone __________________ Other person(s) to notify __________________ Relationship _________ Home Phone _________________ Work Phone ______________________
NATIONAL SPORTS ENTERTAINMENT & RECREATION ASSOCIATION www.nsera.com/paintball
Industry Insurance Programs
Madd Dogz Paintball Park = MDPP
Phone: (214) 228-9585
READ CAREFULLY
WAIVER AND RELEASE OF LIABILITY In consideration of MDPP 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 MDPP; 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 MDPP, 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 MDPP 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 MDPP. This waiver is good through 12/31/2013.
MEDICAL PERMISSION AUTHORIZATION If the participant is of minority age, the undersigned parent or guardian hereby gives permission for MDPP to authorize emergency medical treatment as may be deemed necessary for the child named below while participating in paintball games. I HAVE READ THE ABOVE WAIVER AND RELEASE AND BY SIGNING IT AGREE IT IS MY INTENTION TO EXEMPT AND RELIEVE MDPP FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE.
___________________________________ __________
________________
________________________
Print Name
Date of Birth
Phone
Age
___________________________________ ____________________________ ________________________ Signature
Address
City, State Zip
_______________________________________________ __________________________________________ Signature of Parent/Guardian (if less than 18 years old) E-mail Date: _________________________________________
GENERAL INFO Date: Sunday, April 5
Time: 2pm - 5pm
Where: Madddogz Paintball, 410 Mushroom Road
Waxahachie, TX 75165-6108 Price: $25 (check or cash - make check to Stonegate Church) Price Includes:
-Gun (you can bring your own if you want)
-Mask
-Paintballs
-Enough paintball matches to cover 3 hours!
Meeting: We are all going to just meet at Madddogs. You are free to arrange car pooling on your own.
Other info: Parents (Dads escpecially!) are more than welcome to come! You can bring additional money for snacks.
TO REGISTER
1) Fill out the Stonegate Release Form (other side of this form) 2) Fill out the Madddogs Waiver (stapled to this form of online) 3) Pay $25 Per Player (Cash or Check to Stonegate Church) & turn in to Dan Hutchins on or before April 5.
PAINTBALL 2013 RELEASE FORM
Stonegate Church Medical form (Please print legibly) I,_______________________(parent/guardian), agree to allow my child, _________________________ to attend Madddogs Paintball in Waxahachie, TX with Stonegate Church of Midlothian, TX. I also authorize medication and surgical treatment, as needed, for any accident that may occur involving my child, and release the church from any liability in the case of a medical emergency. I UNDERSTAND AND HEREBY AGREE TO ASSUME ALL OF THE RISKS WHICH MAY BE ENCOUNTERED ON SAID ACTIVITY, INCLUDINGACTIVITIES PRELIMINARY AND SUBSEQUENT THERETO. I do hereby agree to hold Stonegate Church and its agents and employees harmless from any and all liabilityaction, causes of actions claims, expenses, and damages on account of injury to my child,property, even injury resulting in death, which I now have or which may arise in the future in connection with the activity or participation in any other associated activities. I expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as permitted by the law of the State of Texas and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement between the parties hereto and the terms of this release are contractual and not a mere recital. Parent’s Signature _________________________________________ Home Phone _________________ Work Phone __________________ Other person(s) to notify __________________ Relationship _________ Home Phone _________________ Work Phone ______________________
NATIONAL SPORTS ENTERTAINMENT & RECREATION ASSOCIATION www.nsera.com/paintball
Industry Insurance Programs
Madd Dogz Paintball Park = MDPP
Phone: (214) 228-9585
READ CAREFULLY
WAIVER AND RELEASE OF LIABILITY In consideration of MDPP 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 MDPP; 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 MDPP, 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 MDPP 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 MDPP. This waiver is good through 12/31/2013.
MEDICAL PERMISSION AUTHORIZATION If the participant is of minority age, the undersigned parent or guardian hereby gives permission for MDPP to authorize emergency medical treatment as may be deemed necessary for the child named below while participating in paintball games. I HAVE READ THE ABOVE WAIVER AND RELEASE AND BY SIGNING IT AGREE IT IS MY INTENTION TO EXEMPT AND RELIEVE MDPP FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE.
___________________________________ __________
________________
________________________
Print Name
Date of Birth
Phone
Age
___________________________________ ____________________________ ________________________ Signature
Address
City, State Zip
_______________________________________________ __________________________________________ Signature of Parent/Guardian (if less than 18 years old) E-mail Date: _________________________________________
