Mask #:__________ Marker #: ___________ Pods #: ____________ Arm Band: ___________

RIVER VALLEY PAINTBALL GAMES, INC

WAIVER AND RELEASE OF LIABILITY

PLEASE PRINT:

Name: First__________________________________       Last______________________________

Street Address: _________________________________________________________________

City: _________________________       State: _____________       Zip: __________

Date of Birth:__________________________________       Age: ______________

Phone Number: (____)_______________       E-mail Address: __________________________

I WILL ALWAYS WEAR GOGGLES IN OR NEAR PLAYFIELD.

I am completely aware of all the risk, involved and that there is the possibility of additional risk if paintball gun or other equipment does not function properly. I also agree to indemnify the lessor and employees against and shall hold both harmless from any and all claims, actions, suits, procedures, cost, expenses, damages and liabilities, including attorney’s fees arising out of, connected with or resulting from playing Paintball and/or the equipment, including without limitation, the manufacturer, selection, deliver, possession, use operation of the equipment and the environment. I nevertheless wish to assume any and all risks; I hereby waive and release the lessor on behalf of my estate and all others who may play Paintball with me. I also undertake to always play Paintball only in accordance with the safety instructions, rules and suggestions presented to me. Knowing full well the intense instructions, rules and suggestions presented to me. Knowing full well the intense physical/mental exertion required to play Paintball, I further warrant that I have no medical problems that this increase in physical/mental exertion would cause me and others harm. I have read and fully understand the terms of this lease agreement. THIS IS FULLY INTENDED TO BE A LEGALLY BINDING CONTRACT. IF YOU HAVE ANY DOUBTS CONCERNING ANY ASPECT OF ITS CONTENTS, CONSULT AN ATTORNEY BEFORE SIGNING IT.

I STATE THAT I AM AT LEAST 18 YEARS OF AGE AND IN GOOD HEALTH.

Player Signature   __________________________________     Date: ____________
I will abide by all safety rules.
Under 18 Player Signature __________________________________

I HAVE READ AND UNDERSTAND THE ABOVE WAIVER/RELEASE AND I GIVE PERMISSION FOR MY CHILD TO PARTICIPATE IN PAINTBALL GAMES.
Parent Signature will allow child under 18 to participate for the current calendar year.
_________________________________________________
Parent Signature __________________________________Date: ________________

Parent Printed Name ___________________________________________________