2009 MEDICAL RELEASE WAIVER (for 17 and under)
Posted: Tue Jan 06, 2009 2:11 am2009 MEDICAL RELEASE WAIVER, BAD KARMA AIRSOFT FIELD, FOR NO ALLEGIANCE PLAYDATE
I/we being the legal guardians of __________________________________,(here after listed as Minor), a minor under the age of 18, do hereby appoint No Allegiance Officials (David Smith / Steven Byrd), to act on my/our behalf in the event of an emergency or in the event that I/ we cannot be contacted, to authorize, offer or refuse necessary treatment while on the property of the Bad Karma Airsoft field.I understand that I will be responsible for the payment of all costs incurred incident to such treatment. I/WE the undersignes, release Bad Karma Airsoft, Mike Collinsworth, David Smith, Steven Byrd, No Allegiance Officials, the owners, operators, participants, sponsors and all of their agents and employees from any and all responsibilities for any bodily, mental harm or omission that may arise from the participant utilizing the field. By my below signature I agree that I release any and all of the above named, for any outcome or omission that may arise from the offering of medical assistance to the above listed Minor. I understand that there are no guarantees that trained medical staff will ever be on hand at any time and that any aid offered is done so strictly in the manner of a Good Samaritan. By Signing, I wish this WAIVER to be OPEN DATED FOR THE YEAR 2009, allowing the above person permission to play under the above Medical Release at No Allegiance Airsoft game days, played at the BAD KARMA/ LEBANON Airsoft field.
Legal Signatures of all legal guardians:
Legal Guardians Name _____________________ Signature ________________________Date ___/___/___
Legal Guardians Name _____________________ Signature ________________________Date ___/___/___
Legal Guardians Name _____________________ Signature ________________________Date ___/___/___
Legal Guardians Name _____________________ Signature ________________________Date ___/___/___
Legal Signature of participant (even if under 18)
Participant Name __________________________ Signature _________________________Date ___/___/___
I/we being the legal guardians of __________________________________,(here after listed as Minor), a minor under the age of 18, do hereby appoint No Allegiance Officials (David Smith / Steven Byrd), to act on my/our behalf in the event of an emergency or in the event that I/ we cannot be contacted, to authorize, offer or refuse necessary treatment while on the property of the Bad Karma Airsoft field.I understand that I will be responsible for the payment of all costs incurred incident to such treatment. I/WE the undersignes, release Bad Karma Airsoft, Mike Collinsworth, David Smith, Steven Byrd, No Allegiance Officials, the owners, operators, participants, sponsors and all of their agents and employees from any and all responsibilities for any bodily, mental harm or omission that may arise from the participant utilizing the field. By my below signature I agree that I release any and all of the above named, for any outcome or omission that may arise from the offering of medical assistance to the above listed Minor. I understand that there are no guarantees that trained medical staff will ever be on hand at any time and that any aid offered is done so strictly in the manner of a Good Samaritan. By Signing, I wish this WAIVER to be OPEN DATED FOR THE YEAR 2009, allowing the above person permission to play under the above Medical Release at No Allegiance Airsoft game days, played at the BAD KARMA/ LEBANON Airsoft field.
Legal Signatures of all legal guardians:
Legal Guardians Name _____________________ Signature ________________________Date ___/___/___
Legal Guardians Name _____________________ Signature ________________________Date ___/___/___
Legal Guardians Name _____________________ Signature ________________________Date ___/___/___
Legal Guardians Name _____________________ Signature ________________________Date ___/___/___
Legal Signature of participant (even if under 18)
Participant Name __________________________ Signature _________________________Date ___/___/___