BELEGARTH MEDIEVAL COMBAT SOCIETY
“BATTLE FOR THE RING V” presented by Sword at UCI Belegarth Medieval Combat Society
WAIVER AND RELEASE
I agree to abide by all federal, state, Prado Regional Park, and Belegarth Medieval Combat Society Rules by signing this waiver.
In consideration of receiving permission from the Sword at UCI Belegarth Medieval Combat Society to participate as a member of Sword at UCI Belegarth and to participate in any activity, event, tournament, contest or meeting that the Sword at UCI Belegarth participates, sponsors, attends, or supervises, the Undersigned releases Sword at UCI Belegarth, the owner of any premises where any Sword at UCI Belegarth activity, event, tournament, contest or meeting occurs, and any other member of Sword at UCI Belegarth, individually, from any and all liability, claims, demands, actions, and causes of action, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the Undersigned, or any property of the Undersigned, while participating in any activity, event, tournament, contest or meeting that the Sword at UCI Belegarth participates, sponsors, attends or supervises.
INITIALS______.
The Undersigned being duly aware of the risks and hazards inherent upon participating in any activity, event, tournament, contest or meeting of Sword at UCI Belegarth, elects voluntarily to participate, knowing that participation requires physical contact by others to the person of the Undersigned and knowing that such participation may become hazardous and dangerous during the time that the Undersigned voluntarily assumes all risks of loss, damage, or injury, including death, that may be sustained by the Undersigned, or any property of the Undersigned while participating in any activity, event, tournament, contest, or meeting that Sword at UCI Belegarth participates, sponsors, attends or supervises. INITIALS______.
This release shall be binding upon the distributees, heirs, next of kin, executors and administrators of the Undersigned.
In signing the foregoing release, the Undersigned acknowledges and represents:
(a) That he or she has read the above release, understands it, and signs voluntarily;
(b) That he or she is over 18 years of age OR if under 18 has the consent of a parent or legal guardian, and is of sound mind. INITIALS OF PARENT OR GUARDIAN (if under 18):______.
(c) Undersigned represents that he or she has no physical or mental defects known to the Undersigned and unknown to the appropriate representative of the Sword at UCI Belegarth that would endanger or harm the Undersigned while participating in any activity, event, tournament, contest or meeting that Sword at UCI Belegarth participates, sponsors, attends, or supervises. INITIALS______.
Undersigned (Sign name here)
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Address
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City, State, and Zip
Fill out bottom portion only if under 18:
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Chaperone Name and Phone (if player under 18):
Notary Information (if player under 18): / ______
Undersigned (Print name here)
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Fighting Name (Print)
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Emergency phone: Name Emergency Contact:
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Signature of Guardian/Parent______
Print Name Parent/Guardian______
Date Signed: ______
Name of Witness:______