Loading...

APPLICATION AND WAIVER/RELEASE OF LIABILITY AND MEDICAL RELEASE WAIVER FOR PARTICIPATION AT ACS AIRSOFT FIELD, 7400 OLD HWY 60 W, WEST PADUCAH, KY

Medical Release

I/we being the legal guardians of a minor, do hereby appoint ACS AIRSOFT (Preston Roberts), 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 ACS Airsoft field.

I understand that I will be responsible for the payment of all costs incurred incident to such treatment. I will not hold ACS Airsoft, Preston Roberts, the owners, operators, participants, sponsors and all of their agents and employees responsible for any bodily, mental harm or omission that may arise from the participant utilizing the field, and I also agree not to hold responsible any of the above named for any outcome or omission that may arise from the offering of medical assistance to the participant. 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. 

As a prospective participant in the sport of Airsoft, it is extremely important that you have an understanding of the risks of personal injury and/or death that are associated with the sport. The following is intended inform you of the general nature of those risks before your participation begins. The following is not intended to be an exhaustive discussion of those risks. Accordingly, should you have any questions pertaining to the nature and extent of those risks you should question the management of this field. Only after you have satisfied yourself as to the nature and extent of the risks involved as a participant in Airsoft should you sign this document. If I (Suzanne Roberts, owner of this property) do not have a waiver on file for any participant who is on the field playing, then that person or persons does NOT have permission to be on the property for any reason and shall be deemed to be trespassing upon the property and the proper law enforcement officials will be notified. Even if there is no waiver on file for an individual, then the body of the waiver contained herein shall be deemed the governing body for said person in regards to personal or physical injury either to the person himself or property. Trespassing charges may be added on top of this action as well.

  1. The sport of Airsoft is an inherently dangerous activity. The game involves the use of high powered guns (air rifles) that fire plastic pellets at high velocities. Without adequate protection these pellets could break or penetrate the skin on impact. Should a pellet strike a person in the eyes, ears, nose or any vital area of the body that is not adequately protected, temporary or permanent injury, or in extreme circumstances, death, may occur.
  2. Participants play the game on rough and hazardous terrain. This facility takes absolutely no responsibility for the safety of the field. If you play, you are assuming all risks involved and understand that the field is provided in “as is” condition. The risk of injury OR gross negligence on the part of the owner or other participant exists and there remains the risk that a participant could be injured as a result of the hazardous nature of the terrain, the structures, other participants or the nature of the game itself. By signing this waiver OR choosing to participate in ANY EVENT on the property known as "ACS Airsoft Field" all individuals, their guardians or respective representatives knowingly give up and forever abandon any and all attempts at any form of recompensation due to any injury sustained while on the property.
  3. The sport of Airsoft involves rigorous and strenuous physical activity on the part of the participant. Accordingly, a person should not participate in the sport if he or she is not in good physical condition, or has any physical or mental illness or handicap which could be worsened by such participation or make the participant more vulnerable to physical injury or death. In some cases, players may be exposed to plants or elements that could cause serious injury as a result of an allergic reaction. By signing this form, you and every legal guardian that can claim you as a dependent or child, or duly appointed representative are attesting to the fact that you are in sufficient medical and physical shape to play the sport on the ACS Airsoft field.
  4. It shall be the responsibility of each participant to obey all rules and utilize all safety equipment at all times. Safety equipment is designed to minimize the risk of injury and/or death, but its proper use does not guarantee that such injury will not occur. This field does not employ the active use of referees or individuals whose duty it is to maintain an active, vigilant watch during play. There is no stated adult supervision on the field at any time. At no time while a participant is on the field is there any stated person other than the participant whose job it is to make sure that all safety rules and regulations are followed. This is the responsibility of the individual playing and absolutely no implications otherwise are being made contrary to that option. By signing this waiver, you and your guardians are stating that you fully understand that the participant and ONLY THE PARTICIPANT is responsible for their safety while on this property.

By signing this Waiver/Release the undersigned (and, if applicable, his or her guardian(s)) acknowledges that he/she has read the foregoing disclosures of the risks and, further, agrees that he/she assumes all such risks and will hold the owners, operators, participants, sponsors and all of their agents and employees completely free and harmless from any and all damages from physical injuries and/or death which may result from the undersigned's participation whether outside or inside any of the fields facilities or geographical boundaries. Also, by signing this waiver the participant and guardians listed agree to the same above conditions should any damage arise to their physical or personal property. Furthermore, by signing this waiver, you are stating that you are of sound mind and body and FULLY understand the document which you are signing. If parents or legal guardians are signing, they too, state that they are of sound mind and body and are fully aware of the details of this document and the risks involved with a child playing this sport. They too, are also bound by any and all statements made within this document. Parents or legal guardians are not required to remain on site while their children are playing as long as the child is aged 14 years or older, but if they choose to leave, they knowingly give up the right of adult supervision of children on the premises. There is NO SPECIFIED ADULT SUPERVISION ON THE FIELD AT ANY TIME. This means that even though adults may be present during play, they are NOT there in any official monitoring capacity and cannot be held accountable in such a capacity.

If participant is 17 years of age or under, his/her legal guardians must also sign below: All items in BOLD MUST BE FILLED OUT PRIOR TO PLAYING OR ENTERING THE FIELD 

Participant / IF UNDER 18 Legal Guardians Signature:


Dated: November 21, 2024

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
I wish this to be an open dated waiver allowing the above person permission to play anytime they are at the Airsoft playing field during the current calendar year season.
I wish this to be an open dated medical release waiver allowing the above person permission to play anytime they are at the ACS Airsoft West Paducah, KY Airsoft playing field during the current calendar season.
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
I wish this to be an open dated waiver allowing the above person permission to play anytime they are at the Airsoft playing field during the current calendar year season.
I wish this to be an open dated medical release waiver allowing the above person permission to play anytime they are at the ACS Airsoft West Paducah, KY Airsoft playing field during the current calendar season.
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
I wish this to be an open dated waiver allowing the above person permission to play anytime they are at the Airsoft playing field during the current calendar year season.
I wish this to be an open dated medical release waiver allowing the above person permission to play anytime they are at the ACS Airsoft West Paducah, KY Airsoft playing field during the current calendar season.
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
I wish this to be an open dated waiver allowing the above person permission to play anytime they are at the Airsoft playing field during the current calendar year season.
I wish this to be an open dated medical release waiver allowing the above person permission to play anytime they are at the ACS Airsoft West Paducah, KY Airsoft playing field during the current calendar season.
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
I wish this to be an open dated waiver allowing the above person permission to play anytime they are at the Airsoft playing field during the current calendar year season.
I wish this to be an open dated medical release waiver allowing the above person permission to play anytime they are at the ACS Airsoft West Paducah, KY Airsoft playing field during the current calendar season.
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
I wish this to be an open dated waiver allowing the above person permission to play anytime they are at the Airsoft playing field during the current calendar year season.
I wish this to be an open dated medical release waiver allowing the above person permission to play anytime they are at the ACS Airsoft West Paducah, KY Airsoft playing field during the current calendar season.
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
I wish this to be an open dated waiver allowing the above person permission to play anytime they are at the Airsoft playing field during the current calendar year season.
I wish this to be an open dated medical release waiver allowing the above person permission to play anytime they are at the ACS Airsoft West Paducah, KY Airsoft playing field during the current calendar season.
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
I wish this to be an open dated waiver allowing the above person permission to play anytime they are at the Airsoft playing field during the current calendar year season.
I wish this to be an open dated medical release waiver allowing the above person permission to play anytime they are at the ACS Airsoft West Paducah, KY Airsoft playing field during the current calendar season.
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
I wish this to be an open dated waiver allowing the above person permission to play anytime they are at the Airsoft playing field during the current calendar year season.
I wish this to be an open dated medical release waiver allowing the above person permission to play anytime they are at the ACS Airsoft West Paducah, KY Airsoft playing field during the current calendar season.
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
I wish this to be an open dated waiver allowing the above person permission to play anytime they are at the Airsoft playing field during the current calendar year season.
I wish this to be an open dated medical release waiver allowing the above person permission to play anytime they are at the ACS Airsoft West Paducah, KY Airsoft playing field during the current calendar season.
Parent or Guardian's Email Address

Email*
Check to receive information, news, and discounts by e-mail.
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
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*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
I wish this to be an open dated waiver allowing the above person permission to play anytime they are at the Airsoft playing field during the current calendar year season.
I wish this to be an open dated medical release waiver allowing the above person permission to play anytime they are at the ACS Airsoft West Paducah, KY Airsoft playing field during the current calendar season.
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 - TRY IT FREE!