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CLICK HERE FOR A
PDF VERSION
OF THE INSURANCE WAIVER
GAMELINES ARCHERY CLUB, Inc.
WAIVER AND RELEASE OF LIABILITY - READ
BEFORE SIGNING!
In consideration of being allowed to participate in any way in
Gamelines Archery Club (hereafter designated, Gamelines) events and activities,
the undersigned acknowledges, appreciates, and agrees that:
1) The risk of injury from archery and other known and unknown events and
activities and/or the use of the related buildings, structures, equipment,
automobiles, firearms, weapons. ATVs. boats, tree stands, roads, bodies of
water, land and all other real and personal property whether owned by Gamelines
or others is significant, including the potential for permanent paralysis and
death, and while particular rules, equipment, and personal discipline may reduce
this risk, the risk of serious injury docs exist; and,
2) I acknowledge and agree that the use of archery equipment, firearms and other
weapons by myself or others on club premises or otherwise are inherently
dangerous and high risk activities whether such archery equipment, firearms or
weapons arc discharged by myself or others; and
3) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown,
EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and
assume full responsibility for my participation; and,
4) I willingly agree to comply with the stated and customary terms and
conditions for participation. If, however, I observe any unusual significant
hazard during my presence or participation, I will remove myself from
participation and bring such to the attention of the nearest official
immediately; and,
5) I, for myself and on behalf of my heirs, assigns, personal representatives
and next of kin, HEREBY RELEASE AND HOLD HARMLESS GAMELINES, its officers,
directors, officials, agents, employees, volunteers, members, guests, other
participants, sponsoring agencies, sponsors, advertisers, and if applicable,
owners and lessors of real property and personal property used to conduct the
events and activities ("RELEASEES"), WITH RESPECT TO ANY AND ALL
INJURY, DISABILITY, DEATH, or loss or damage to person or properly, WHETHER
ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, TO THE FULLEST EXTENT
PERMITTED BY LAW.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK
AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP
SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY
INDUCEMENT. All GUESTS WHO ATTEND WITH ME WILL ALSO SIGN THIS WAIVER.
Participant’ Name:
______________________________________
Spouse Signature (Must Sign if a Member or Guest)
______________________________
Participant's Signature: __________________________________
Date Signed:
__________________
Emergency Phone Number:
_________________________________________
**********************************************************************************************************************
FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE - 18, AT
THE TIME OF PARTICIPATION)
All Minors Who Shoot at the Range Must Be Listed!
This is to certify that I, as parent/guardian with legal responsibility for
this participant, do consent and agree to his/her release as provided above of
all the Releasees, and for myself, my heirs, assigns, and next of kin. I release
and agree to indemnify and hold harmless the Releasees from any and all
liabilities incident to my minor child's involvement or participation in these
events and activities and/or the use of related real and personal property as
provided above. EVEN IF ARISING FROM THEIR NEGLIGENCE.
1st Minor Name:
___________________________________ 2nd Minor Name:
_____________________________________
3rd Minor Name: __________________________________ 4th
Minor Name: ______________________________________
5th Minor Name: _________________________________
Parent Signature for Minors:
_______________________________________ Date:
______________________________
©
1998-2005 Sadllcr & Company, Inc.
All Rights Reserved
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