Riverport and Starnet Insurance Companies COSSIO Insurance Agency 864-688-0121 Professional Paintballers Extreme Battlefield Read Carefully (956) 461-3100 Waiver and Release of Liability In consideration of PPEB furnishing services and/or equipment to enable me to participate in paintball games, I agree as follows: I fully understand and acknowledge that; (A) risk 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 may not be limited to bodily injury, disease strains, fractures, partial and/or total paralysis, eye injury, blindness, heat stroke, heart attack, death, or other aliments that could cause serious disability; (C) these risks and dangers may be caused by the negligence of owners, employees, officers or agents of PPEB, the negligence of the participants, 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, weather caused in whole or in part by the negligence of other conduct of the owners, agents, officers, employees, of PPEB or by any other person. I, on behalf of myself, my personal representatives and my heirs, hereby voluntarily agree to release, wave, discharge, hold harmless, defend and indemnify PPEB and its 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 waving my claims or actions that may have presently or in the future for the negligent acts of other conduct by the owners, agents, officers, or employees of PPEB. Medical Permission Authorization If the participant is of minority age, the undersigned parent or guardian hereby give permission to EB to authorize emergency medical treatment as may be deemed necessary for the child named below while participating in paint ball games. I have read the above waiver and release and by signing it, I agree it is my intention to exempt and relieve EB from liability for personal injury property damage or wrongful death caused by the negligence or any other cause. Print Name Signature Signature of Parent/Guardian (If less that 18 years old) Todays Date Age Date of Birth Address City Email Phone State Zip Rules If you do not obey the rules, you will be asked to leave without refund! NO EXCEPTIONS! 1. Masks o at all time in the field. 2. Barrel socks on at all times out of the field. 3. NO swearing, fighting, or foul play. 4. You may not play with velocity over 280FPS. 5. No shooting out of the playing field. 6. No outside paint with home guns. 7. You may NOT use or pick up paintballs that have fallen on the floor. 8. Spectators must 3 feet away front he nets. 9. No shooting at wildlife. 10. No drugs or alcohol. 11. No automatic or over 3 shot burst. 12 You are responsible to pay for any of our equipment that is lost or stolen. 13. No food or drinks in the field. 14. Pick up your trash. 15. We have the right to refuse service. 16. We are NOT responsible for you lost or stolen items. 17. Treat our equipment with respect, clean it, and do not trash it. 18. We are not responsible for any children supervised or unsupervised, parents must supervise children at all times and must not leave children unattended on parks ground. 19. We are NOT responsible for any accidents. Players Signature
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