Loading...

              NATIONAL SPORTS ENTERTAINMENT & RECREATION ASSOCIATION

Industry Insurance Programs                                                           www.nsera.com/paintball

Combat Zone Paintball Inc. = CZP                                                   Phone: (702) 388-9663

                                                  

READ CAREFULLY

WAIVER AND RELEASE OF LIABILITY
In consideration of CZP 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 CZP; 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 CZP, 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 CZP 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
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 CZP. This waiver is good through 11/9/2019

 

MEDICAL PERMISSION AUTHORIZATION

If the participant is of minority age, the undersigned parent or guardian hereby gives permission for CZP

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 CZP FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL
DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE.

 Important Instructions

If you are under 18 years old you need to have someone 18 or older click Minor below and sign for you.

December 11, 2018 

Please select who will be participating...
AdultMinor
Continue
First Participant Name

First Name*

Last Name*

Phone*
First Participant Date of Birth*
First Participant Signature*
Parent or Guardian's Email Address

Email
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Signature of Parent/Guardian (If less than 18 years old) is necessary
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver