Player Waiver and Release of Liability
Submit electronically.  Printed versions will not be accepted.
Players under 18 MAY NOT fill out their own waivers.  We have the right to contact all parents to verify information.

Venue:
1260 Rancho Conejo Blvd #1
Newbury Park, CA 91320
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Direct any inquiries to the following:

805-498-9186
www.patriotcqb.com



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Membership
First Name
Last Name
What is PLAYERS' birth date?
Email
Address
City
State
Zip
Emergency Number
Is the PLAYER OVER 18?
Parents Name
Parent Phone Number
Parent's Birth Date
If attending a PRIVATE birthday party, please tell us the birthday persons name.
Terms
I ACKNOWLEDGE THAT I AM OVER THE AGE OF 18 OR A LEGAL GUARDIAN OR PARENT OF THE ABOVE PLAYER. PLAYERS MAY BE ASKED FOR IDENTIFICATION. Those under 18 are prohibited from signing their own waivers. Parents can be contacted to verify they electronically signed this waiver.
In consideration of Patriot Airsoft, LLC furnishing services and /or equipment to enable me to participate in Airsoft/ Nerf games, I agree as follows:
I fully understand and acknowledge that; (a) risks and dangers exist in my use of Airsoft/ Nerf equipment and my participation in Airsoft/ Nerf activities; (b) my participation in such activities and/or use of such equipment may result in my injury or illness including but not limited to bodily injury, disease strains, fractures, partial and/or total paralysis, eye injury, blindness, heat stroke, heart attack, death or other ailments that could cause serious disability; (c) these risks and dangers may be caused by the negligence of the owners, employees, officers or agents of Patriot Airsoft, LLC; the negligence of the participants, the negligence of others, accidents, breaches of contract, the forces of nature or other causes. These risks and dangers may arise from foreseeable or unforeseeable causes; and (d) 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 negligence or other conduct of the owners, agents, officers, employees of Patriot Airsoft, LLC, or by any other person.
I, on behalf of myself, my personal representatives and my heirs, hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify Patriot Airsoft, LLC and itís owners, agents, officers and employees from any and all claims, actions or losses for bodily injury, property damage, wrongful death, loss of services or otherwise which may arise out of my use of Airsoft equipment or my participation in Airsoft 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 Patriot Airsoft, LLC.

I HAVE READ THE ABOVE WAIVER AND RELEASE AND BY SIGNING IT AGREE IT IS MY INTENTION TO EXEMPT AND RELIEVE PATRIOT AIRSOFT, LLC FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE. I UNDERSTAND THAT I MUST BE 18 YEARS OR OLDER TO SIGN THIS WAIVER. IF NOT 18+ A PARENT MUST APPROVE THIS WAIVER. PATRIOT AIRSOFT HAS THE RIGHT TO VERIFY ANY PART OF THIS WAIVER.

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Check this box to indicate that you have read and agree to all of the above terms & conditions
Parent Initials (Electronically agreeing to the above terms)

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