Activity Participation Agreement -- Paintball

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    08-Apr-2016

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<ul><li><p> _____________________________________________________________________________</p><p>_______________</p><p>Ac#vity Par#cipa#on Agreement for Paintball</p><p>Par$cipant Informa$on (to be completed by Par$cipant or authorized guardian)</p><p>Name of Par#cipant: ____________________________________________ Phone: ____________________</p><p>Name of Parents/Guardians: ______________________________________ Phone: ___________________</p><p>Address: ________________________________________________________________________________</p><p>Name of Emergency Contact: ______________________________________ Phone: ___________________</p><p>List allergies or medical condi#ons: ____________________________________________________________</p><p>Is sponsor authorized to approve medical treatment? Yes No Is par#cipant covered by personal/family medical insurance? Yes No If yes, Name of Insurer: ____________________________________________________________________Policy &amp;/or Group Number: _________________________________________________________________ Par$cipa$on Agreement:I acknowledge that par#cipa#on in the paintball ac#vity (referred to hereinaJer as the Ac#vity) at FairlawnCommunity Church involves risk to the Par#cipant (and to Par#cipants parents or guardians, if Par#cipant is aminor), and may result in various types of injury including, but not limited to, the following: sickness, bodilyinjury, death, emo#onal injury, personal injury, property damage and nancial damage. In considera#on forthe opportunity to par#cipate in the Ac#vity, the Par#cipant (or parent/guardian if Par#cipant is a minor)acknowledges and accepts the risks of injury associated with par#cipa#on in and transporta#on to and fromthe Ac#vity. The Par#cipant (or parent/guardian) accepts personal nancial responsibility for any injury orother loss sustained during the Ac#vity or during transporta#on to and from the Ac#vity, as well as for anymedical treatment rendered to the Par#cipant that is authorized by the Sponsor or its agents, employees,volunteers, or any other representa#ves (collec#vely referred to hereinaJer as the Ac#vity Sponsor).Further, the Par#cipant (or parent/guardian) releases and promises to indemnify, defend, and hold harmlessthe Ac#vity Sponsor for any injury arising directly or indirectly out of the described Ac#vity or transporta#onto and from the Ac#vity, whether such injury arises out of the negligence of the Ac#vity Sponsor, thePar#cipant, or otherwise.</p><p>If a dispute over this agreement or any claim for damages arises, the Par#cipant (or parent/guardian) agreesto resolve the maUer through a mutually acceptable alterna#ve dispute resolu#on process. If the Par#cipant(or parent/guardian)and the Ac#vity Sponsor cannot agree upon such a process, the dispute will be submiUedto a three-member arbitra#on panel for resolu#on pursuant to the rules of the American Arbitra#onAssocia#on. I have read and agree to follow all Rules and Guidelines on the reverse side of this Agreement.Signature: ______________________________________________________________ Date: ____________________Signature: ______________________________________________________________ Date: ____________________(Par$cipant and Parent/Guardian signatures are required if Par$cipant is a minor)</p><p>RULES AND GUIDELINES FOR FCC PAINTBALL Minors under the age of 18 must bring a parent or release form signed by aparent or guardian in order to play. Listen to your referees at all times. Bring a good attitude and any equipment you feel you will need (gun, mask,clothing). FCC has rental equipment available at $15.00 for gun, air tank, maskand 500 paintballs. Do not bring paint purchased elsewhere. Due to safety, liability,and other concerns, outside paint is not allowed. Paint purchased previously at ourfield is allowed, but will be inspected by the staff.</p></li><li><p>clothing). FCC has rental equipment available at $15.00 for gun, air tank, maskand 500 paintballs. Do not bring paint purchased elsewhere. Due to safety, liability,and other concerns, outside paint is not allowed. Paint purchased previously at ourfield is allowed, but will be inspected by the staff. All Players must wear an approved safety mask which covers the eyes, faceand ears. All masks brought in by players are subject to inspection and approval byour staff. Equipment deemed inadequate or unsafe will not be allowed. Whenever masks are not being worn, all guns should be blocked with a barrelsock. Safeties are good and should be used, but they often fail or are not properlyused, and a physical protection from wayward paintballs is a must. Unless everyonehas a mask on, do not take out your barrel plug. Keep masks on until barrel socks have been placed back on all loaded guns.Never lift your mask until told to do so. This is for your own safety. The greatestdanger to you when playing paintball is a stray shot to the eye. Under NOcircumstances will lifting of the mask be tolerated! If caught lifting the mask you willbe sentenced to our "time out chair" as a reminder of the danger. If you refuse thisreminder, or have repeat violations, you will be asked to leave the premises. (Thoseasked to leave will receive no refund.) Surrenders: 10 foot rule- We play friendly recreational paintball at FCC. If you"surprise" someone or "bunker" them (have them trapped at point blank range), justyell surrender and they are out. DO NOT SHOOT. Modern paintball guns shootpaintballs at velocities up to 300 feet per second and a shot at close range is painful.NO PHYSICAL CONTACT. We are here to have fun! No blind firing- Do not fire if you cannot see what you are firing at. Many playersare tempted to stick their guns out and fire without looking, but avoid this. Blind firingcan lead to accidentally shooting players who are leaving the field, referees, or otherthings you shouldnt shoot. No climbing- Players should never climb any trees or structures. During play, allactivity should be on ground level within inspected and approved areas. No unauthorized equipment- Players are not allowed to bring onto the playingfield any equipment deemed to be unsafe or not appropriate by the FCC staff.Players are never allowed to bring onto the field knives of any size, tools of any sort,matches, lighters, hatchets, paint grenades or mines, multiple paintball launchers,pyrotechnics, smoke grenades, or any type of explosives. Dress for comfortable movement, safety from insects &amp; ticks, and for the weather.We play regardless of the weather unless conditions become unsafe (lightning, etc.).</p><p> Fairlawn Community Church</p><p>353 Pleasant Hill Road, Cogan Station, PA 17728Phone (570)494-0414 www.fairlawncc.com</p></li></ul>

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