Close Combat (SURV)
West Point, NY 10996
Game Date:
Waiver and Release of Liability Form
Read First before Signing
First Name: Last Name:
Address:
City: State: Zip:
Phone #: () - Email Address:

When participating in Close Combat (ArmyPaintball) activities, services, or equipment, I agree to the following:

I fully understand and acknowledge that:

  1. Risks and dangers exist in my use of Paintball equipment and my participatin in Paintball activities
  2. My participation in such activities and/or use of such equipment may result in my illness including but not limited to dobily injury, disease, strains, fractures, partial and/or total paralysis, eye injury, blindness, heat stroke, heart attack, frostbite, death or other ailments that could cause serious disability
  3. These risks and dangers may be caused by the negligence of the owners. employees, officers or agents of Close Combat; the negligence of the p[articipants, the negligence of others, accidents, breaches of contracts, the forces of nature or other causes. These risks and dangers may arise from foreseen and unforseenable causes;
  4. and 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 neglgence or other conduct of the owners, agents, officers, employees of Close Combat, or by any other person.
I, on behalf of myself, my personal representatives and my heirs, hereby voluntariliy agree to release, waive, discharge, hold harmless, defend and indemnify it's owners, agents, officers and employees from any and all claims or losses for bodily injury, property damage, wrongful death, loss of services or otherwise which may arise out of my use of Paintbll 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 Close Combat.

Age:
Birth Date: Day: Month: Year

SIGNATURE:_______________________________________
I have read and understood the directions
If you are under the age of 18, a parent or gaurdian will be required to sign the form below
First Name: Last Name:
Age: Birth Date of Parent/Gaurdian: Day: Month: Year

SIGNATURE:_______________________________________