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Ac#vity  Par#cipa#on  Agreement  for  Paintball

Par$cipant  Informa$on  (to  be  completed  by  Par$cipant  or  authorized  guardian)

Name  of  Par#cipant:    ____________________________________________    Phone:    ____________________

Name  of  Parents/Guardians:    ______________________________________    Phone:    ___________________

Address:      ________________________________________________________________________________

Name  of  Emergency  Contact:    ______________________________________    Phone:    ___________________

List  allergies  or  medical  condi#ons:    ____________________________________________________________

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  &/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#cipant’s  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  financial  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  financial  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.

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)

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.

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 shouldn’t 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 & ticks, and for the weather.We play regardless of the weather unless conditions become unsafe (lightning, etc.).

Fairlawn Community Church

353 Pleasant Hill Road, Cogan Station, PA 17728Phone (570)494-0414 www.fairlawncc.com