Recreational Activity Release of Liability, Waiver of Claims, Express Assumption Of Risk and Indemnity Agreement for Paintball


TODAY'S DATE: December 10, 2022 VALID UNTIL 31 December 2022


In consideration of Lake Phoenix Paintball furnishing services and /or equipment to enable me to participate in paintball games, I agree as follows:

1. I HEREBY RELEASE AND HOLD HARMLESS WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER CAUSED BY NEGLIGENCE OR OTHERWISE, the following named persons or entities, herein referred to as releases.

2. To release Lake Phoenix Paintball, their officers, directors, employees, representatives, agents, and volunteers, and staff from liability and responsibility whatsoever and for any claims or causes of action that I, my estate, heirs, survivors, executors, or assigns may have for personal injury, property damage, or wrongful death arising from the above activities whether caused by active or passive negligence of the releases or otherwise. By executing this document, I agree to hold the releasees harmless and indemnify there in conjunction with any injury, disability, death, or loss or damage to person or property that may occur as a result of engaging in the above activities.

3. By entering into this Agreement, I am not relying on any oral or written representation or statements made by the releases, other than what is set forth in this Agreement.

This release shall be binding to the fullest extent permitted by law. If any provision of this release is found to be unenforceable, the remaining terms
shall be enforced.

For Participants of Minority Age, this is the clarify that I, as Parent, Guardian, Temporary Guardian with legal responsibility for this participant, do consent and agree not only to his/her release of all releasees, but also to release and indemnify the Releasees from any and all liabilities incident to his/her involvement in these programs for myself, my heir, assigns, and next of kin.

Participants initials

Lake Phoenix | 1 Quarry Lane, Rawlings VA | 23876 | Phone: (804) 716-2199

First Paintball Participants Name

First Name*

Last Name*

First Paintball Participants Date of Birth*
First Paintball Participants Signature*
Second Paintball Participants Name

First Name*

Last Name*
Second Paintball Participants Date of Birth*
Third Paintball Participants Name

First Name*

Last Name*
Third Paintball Participants Date of Birth*
Fourth Paintball Participants Name

First Name*

Last Name*
Fourth Paintball Participants Date of Birth*
Fifth Paintball Participants Name

First Name*

Last Name*
Fifth Paintball Participants Date of Birth*
Sixth Paintball Participants Name

First Name*

Last Name*
Sixth Paintball Participants Date of Birth*
Seventh Paintball Participants Name

First Name*

Last Name*
Seventh Paintball Participants Date of Birth*
Eighth Paintball Participants Name

First Name*

Last Name*
Eighth Paintball Participants Date of Birth*
Ninth Paintball Participants Name

First Name*

Last Name*
Ninth Paintball Participants Date of Birth*
Tenth Paintball Participants Name

First Name*

Last Name*
Tenth Paintball Participants Date of Birth*
Paintball Participants Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Parent or Guardian's Email Address


Confirm Email*
Check to receive information, news, and event notice by e-mail.

Express Assumption of Risk Associated with Recreational Activities

I, the undersigned and any associated minors, hereby affirm and acknowledge that I have been fully informed of the inherent hazards and risks associated with the recreational activity generally described as Paintball including the rental of equipment and transportation associated therewith of which I am about to engage in. Inherent hazards and risks include but are not limited to:

1. Risk of injury from the activity and equipment utilized during 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.

2. Possible equipment failure and/or malfunction of my own or others equipment.

3. This activity takes place outdoors and therefore includes risks associated with exposure to elements, excessive heat, hypothermia, impact of the body upon the water, injection of water or paintball material into my body orifices, encountering objects either natural or man-made, exposure to animals with the attendant risks of kicking, biting, shying away, running off or otherwise moving in an unanticipated manner causing injury and/or death.

4. My own negligence and/or the negligence of others, including but not limited to operator error and guide decision making including misjudging terrain, rapids, weather, trails, and route location. These risks and dangers may be caused by the negligence of the owners, employees, officers or agents of Lake Phoenix Paintball; 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 I and any associated minors accept this risk.

5. Attack by or encounter with insects, reptiles, and/or animals.

6. Accidents or illness occurring in remote places where there are no available medical facilities, or extended response time (~45 minutes at Lake Phoenix Paintball).

7. Fatigue, chill, and/or dizziness, which may diminish my/our reaction time and increase the risk of accident.

*I understand the description of these risks is not complete and that unknown or unanticipated risks may result in injury, illness, or death. 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 Lake Phoenix Paintball, or by any other person.

Terms and Conditions
I understand that Lake Phoenix Paintball, at their sole discretion, may eject me from the facility, without warning or refund, for reasons including, but not limited to, safety rule violations, playing under the influence of alcohol/drugs, use of unauthorized paintballs, or failure to follow staff instructions.

I agree that all paintball markers used at Lake Phoenix Paintball will be Chronograph checked and not used until adjusted to no more than 300FPS.  Paintball markers found to be altered on the field will be removed and player ejected.

I agree that I will not commence play until I have participated in a paintball safety and rules presentation video and or staff briefing.

I grant Lake Phoenix Paintball the right to photograph, videotape, voice record, etc. myself/my child while at Lake Phoenix Paintball and to use said media and/or my/my child's first name/team name for promotional purposes as they see fit.

I, on behalf of myself, my personal representatives and my heirs, hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify Lake Phoenix Paintball 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 Lake Phoenix Paintball.

Medical Permission Authorization
If the participant is of minority age, the undersigned parent or guardian hereby gives permissions for Lake Phoenix Paintball to authorize emergency medical treatment as may be deemed necessary for the child named below while participating in paintball games.


NOTE: Your signature on this agreement is required as proof that you were made aware of and have acknowledged this document and watched the informational video.

I hereby declare that I am of legal age and am competent to sign this waiver and release agreement, or that my parent or guardian will sign this document on my behalf if I am a minor.

Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.

By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

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.

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