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BAZOOKA BALL
WAIVER FORM

Bazooka Ball is a safe game for all ages but under insurance regulations we require a Player waiver. Players (and/or Guardians) understand and agree that these activities are physically and mentally intense and may require extreme exertion to play and the possibility of injury to themselves and others may exist if not played in accordance with stated rules which have been read, understood and will be abided by.

Players (and/or Guardians) signing this waiver hereby release, remise and forever discharge from any claims and liabilities whatsoever without limitations that I might have against Family Karate and any staff or their personnel, indemnifying them against any and all claims, actions, suits, procedures, costs, expenses(including legal fees and expenses), damages and liabilities arising out of, connected with, or resulting from my playing the game or operation of equipment. This release shall be binding upon estates, heirs, representatives and assigns. Players (and/or Guardians) hereby certify to Family Karate that they are in good health and do not suffer from a heart condition or other ailment which could be aggravated by exertion involved in playing the game.

Assumption of risk: Players (and/or Guardians) confirm to have specific insurance to cover any injuries that they may sustain or cause to others and have read and fully understand the terms of this agreement. This is fully intended to be a legally binding contract.

Any violation of these rules when playing Bazooka Ball will result in that player being ejected from play, or the premises at the sole option of the management.

  • Safety goggles must be worn at all times
  • No shooting at the neck or head or outside of play area (arena)
  • All Markers must have safeties on outside of arena
  • Markers may not be taken outside playing area
  • No climbing on structures of any kind
  • No physical contact
  • No outside gear can be brought into arena
  • No alcohol, legal or illegal drugs are allowed on the premises at any time
  • No smoking in building
  • No verbal abuse or profanity allowed
  • Do not remove CO2 tanks or any parts from the markers
  • No blind shooting, players may only shoot what they can see
  • No gum allowed in arena
  • All judges decisions are final
  • Mercy rules in effect. If player calls "mercy" and places hands over head, they must be allowed to return to their home base untouched.
  • No shooting within 10 feet of opponent

BY VIRTUE OF MY SIGNATURE I ACKNOWLEDGE AND AGREE TO ALL TERMS AND CONDITIONS SET FORTH IN THIS FORM.

Today's Date: October 21, 2019

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

Bazooka Ball Event Host: *

Event date is *
The location of the event is: *
North (1695 Wonderland Road N)
South (405 Wharncliffe Road S)

Please list any Medical Conditions: *
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*

Phone*
Second Participant's Date of Birth*
Second Participant's Information

Bazooka Ball Event Host: *

Event date is *
The location of the event is: *
North (1695 Wonderland Road N)
South (405 Wharncliffe Road S)

Please list any Medical Conditions: *
Third Participant's Name

First Name*

Last Name*

Phone*
Third Participant's Date of Birth*
Third Participant's Information

Bazooka Ball Event Host: *

Event date is *
The location of the event is: *
North (1695 Wonderland Road N)
South (405 Wharncliffe Road S)

Please list any Medical Conditions: *
Fourth Participant's Name

First Name*

Last Name*

Phone*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Bazooka Ball Event Host: *

Event date is *
The location of the event is: *
North (1695 Wonderland Road N)
South (405 Wharncliffe Road S)

Please list any Medical Conditions: *
Fifth Participant's Name

First Name*

Last Name*

Phone*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Bazooka Ball Event Host: *

Event date is *
The location of the event is: *
North (1695 Wonderland Road N)
South (405 Wharncliffe Road S)

Please list any Medical Conditions: *
Sixth Participant's Name

First Name*

Last Name*

Phone*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Bazooka Ball Event Host: *

Event date is *
The location of the event is: *
North (1695 Wonderland Road N)
South (405 Wharncliffe Road S)

Please list any Medical Conditions: *
Seventh Participant's Name

First Name*

Last Name*

Phone*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Bazooka Ball Event Host: *

Event date is *
The location of the event is: *
North (1695 Wonderland Road N)
South (405 Wharncliffe Road S)

Please list any Medical Conditions: *
Eighth Participant's Name

First Name*

Last Name*

Phone*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Bazooka Ball Event Host: *

Event date is *
The location of the event is: *
North (1695 Wonderland Road N)
South (405 Wharncliffe Road S)

Please list any Medical Conditions: *
Ninth Participant's Name

First Name*

Last Name*

Phone*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Bazooka Ball Event Host: *

Event date is *
The location of the event is: *
North (1695 Wonderland Road N)
South (405 Wharncliffe Road S)

Please list any Medical Conditions: *
Tenth Participant's Name

First Name*

Last Name*

Phone*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Bazooka Ball Event Host: *

Event date is *
The location of the event is: *
North (1695 Wonderland Road N)
South (405 Wharncliffe Road S)

Please list any Medical Conditions: *
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
I am the parent/guardian of the subject minor(s), and have full knowledge of their presence on these premises and/or their participation in this Bazooka Ball game. I also understand the playing rules and release Family Karate and any staff member from any responsibility of injury caused by or resulting to the participating minor(s).
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

Bazooka Ball Event Host: *

Event date is *
The location of the event is: *
North (1695 Wonderland Road N)
South (405 Wharncliffe Road S)

Please list any Medical Conditions: *
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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