MOA Field Waiver
Application To Play Airsoft Military Op’s Airsoft/Austin Investments LLC (PawPaw Development L&A LLC) Please print this form, fill in the blanks, and give it to the field operator when you arrive at the field. Print Clearly! I, the undersigned, want to play the airsoft activities offered by this playing field, and sign this application in consideration of being given the opportunity to engage in this sport. PLEASE PRINT CLEARLY
Group: _______________ Player’s Name:__________________________________________________
Address: ____________________________________________City: ________________ State: _____
Zip code:____________________D.O.B:____________ Emergency Phone Number: ________________
Email:__________________________________________
DL or State ID Number:____________________________
I understand and acknowledge that: 1. The activities are physically and mentally intense and may require extreme exertion to play and the possibility of injury to myself and others does exist. The acknowledged risks of physical injury include, but are not limited to, risk of bruises, abrasions, contusions, sprains, fractures, serious eye injury or even death. I fully assume the risks of injury inherent in engaging in these activities. 2. The activities can be dangerous and are to be played in accordance with the stated rules, which will be given at the site of the activities. I certify that I fully understand the stated rules of the activity and will abide by them. I confirm and agree that: 1. I am physically and mentally able to be fully involved in these activities and will comply with all rules, regulations and the full and complete use of all equipment so as not to injure or hurt myself or other participants. 2. In consideration, of being permitted to attend and/or participate in the activities, I hereby specifically release, discharge and hold harmless Military Op’s Airsoft (MOA)/Austin Investments LLC (PawPaw Development L&A LCC) and all of its officers, employees, agents and members, without exception, from any and all liability, responsibility, damage or loss, whether known or unknown, existing or potential, that I or anyone else may claim, including but not limited to, personal injury, illness, mental distress or disability of any type, or death, or property damage, whether or not caused by my own negligence or the negligence of anyone else, and whether or not caused by the negligence of Military Op’s Airsoft/Austin Investments LLC (PawPaw Development L&A LCC) or any of its officers, employees, agents, or members, during my attendance of and/or participation in the activities. I further agree to defend and indemnify Military Op’s Airsoft/Austin Investments LLC (PawPaw Developments L&A LCC), its officers, employees, agents and members against any and all claims, legal actions, suits, procedures, costs, expenses (including attorney’s fees and expenses) damages and/or liabilities arising out of, connected with, or resulting from my playing/participating in the airsoft activities, including, without limitation, those resulting from the manufacture, selection, delivery, possession, use or operation of all airsoft equipment. I furthermore fully understand and agree that this release and agreement to provide defense and indemnity as outlined above shall be binding upon my estate, my heirs, my representatives and assigns.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AGREEMENT, AND HAVE VOLUNTARILY AND FREELY SIGNED IT WITH THE INTENT THAT IT BE, AND UNDERSTANDING THAT IT IS, A LEGALLY BINDING CONTRACT. TO THE EXTENT THAT I HAVE ANY DOUBTS CONCERNING ANY ASPECT OF ITS CONTENTS OR THEIR MEANING, I WILL CONSULT AN ATTORNEY BEFORE SIGNING IT. THIS IS A RELEASE, READ BEFORE SIGNING I am at lease 18 years of age and have executed this Agreement on the day, month and year written below.
Applicant’s Signature: _______________________________________________________________
Date of Play: ________________________________________________________________
PARENT OR LEGAL GAURDIAN COMPLETE THIS SECTION IF PLAYER IS UNDER 18 YEARS OLD:
If you are under 18, please have this Agreement guaranteed by having your parent or legal guardian sign below. AGREEMENT: My signature below indicates that I consent to the above minors participation in the above discussed activity and to the terms of all of the obligations this Agreement and have read and fully understand all of its terms.
Parent or Legal Guardian’s Signature:_______________________________________
Parent or Legal Guardian’s name (please print) __________________________________
Relationship __________________ Parent/LG Contact Number:____________________________
Address ______________________________________________________________________
DL/State ID#__________________________________________
Email:__________________________________________________
MOA STAFF ONLY MOA STAFF
SIGNITURE_______________________________________________________________
NOTE: IF YOU ARE UNDER THE AGE OF 18 YOU MUST HAVE YOUR PARENT OR LEGAL GUARDIAN |
